Journal of metabolic syndrome最新文献_第9页

Stroke in Severity of Sickle Cell Diseases 镰状细胞病严重程度的中风

Journal of metabolic syndrome

Pub Date : 2015-04-27 DOI: 10.4172/2167-0943.1000174

M. Helvaci, R. Davran, A. Aydoğan, S. Akkucuk, Mustafa Ugu, C. Oruç

Background: Sickle cell diseases (SCDs) are chronic inflammatory process on capillary level. We tried to understand whether or not there are some positive correlations between stroke and severity of SCDs. Methods: All patients with SCDs were taken into the study. Results: The study included 343 patients (169 females and 174 males). There were 30 cases (8.7%) with stroke. The mean ages were similar in both groups (32.5 versus 29.1 years in the stroke group and other, respectively, p>0.05). The female ratios were similar in both groups, too (43.3% versus 49.8%, respectively, p>0.05). Prevalences of associated thalassemia minors were also similar in them (73.3% versus 65.1%, respectively, p>0.05). Smoking was higher among the stroke cases (26.6% versus 13.0%, p 0.05 for all). On the other hand, although the painful crises per year, tonsilectomy, priapism, ileus, pulmonary hypertension, chronic obstructive pulmonary disease, coronary heart disease, chronic renal disease, rheumatic heart disease, avascular necrosis of bones, cirrhosis, and mortality were all higher in the stroke group, the differences were only significant for digital clubbing, leg ulcers, and acute chest syndrome (p<0.05 for all), probably due to the small sample size of the stroke group. Conclusion: SCDs are chronic destructive process on capillaries iniatiating at birth, and terminate with early organ failures in life. Probably stroke is one of the terminal consequences of the inflammatory process that may indicate shortened survival in such cases.

背景:镰状细胞病(SCDs)是一种毛细血管水平的慢性炎症过程。我们试图了解中风和SCDs严重程度之间是否存在正相关。方法:将所有SCDs患者纳入研究。结果:共纳入343例患者，其中女性169例，男性174例。卒中30例(8.7%)。两组患者的平均年龄相似(卒中组和其他组分别为32.5岁和29.1岁，p < 0.05)。两组的女性比例也相似(分别为43.3%和49.8%，p < 0.05)。两组儿童相关地中海贫血患病率相似(分别为73.3%和65.1%，p < 0.05)。吸烟在中风患者中较高(26.6%比13.0%，p < 0.05)。另一方面，虽然每年的痛苦危机、扁桃体切除术、阴茎勃起障碍、肠梗阻、肺动脉高压、慢性阻塞性肺病、冠心病、慢性肾病、风湿性心脏病、骨缺血性坏死、肝硬化和死亡率在卒中组中都较高，但差异仅在数字棒、腿部溃疡和急性胸综合征方面具有显著性(p<0.05)，这可能是由于卒中组的样本量较小。结论:SCDs是一种慢性的毛细血管破坏过程，始自出生，终于生命早期器官衰竭。中风可能是炎症过程的最终后果之一，这可能表明在这种情况下生存期缩短。

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引用次数: 1

Pull the Trigger, it Fires: The Critical Role of Insulin-Stimulated Caveolin-1 Tyrosine 14 Phosphorylation in Regulation of Insulin Trans-Endothelial Transport 扣动扳机，它就会开火:胰岛素刺激的小窝蛋白-1酪氨酸14磷酸化在胰岛素反式内皮运输调节中的关键作用

Journal of metabolic syndrome

Pub Date : 2015-03-27 DOI: 10.4172/2167-0943.1000E114

Hong Wang

In order for insulin to exert its biological actions on target cells in peripheral tissues like muscle and adipose tissues, Insulin must pass through the endothelial barrier into the interstitium.Insulin’s transendothelial transport (TET), particularly in muscle where capillaries are lined by a continuous endothelium, determines tissue insulin levels, and thereby critically determines insulin’s metabolic effects [1-6]. This process is significantly impaired in insulin resistance states such as obesity and type 2 diabetes [2,7-9]. Current evidence obtained by us and others indicate that insulin TET is transcellular process and mediated by transporting caveolae that contain or associate with multiple structural and signaling molecules including the insulin receptor (IR), IGF-1receptor, caveolin-1, dynamin-2, actin filaments and eNOS [10-18]. Among these components, caveolae and its key structural protein caveolin-1 have been shown to serve as the center to organize the molecular transcytotic machinery mediating insulin TET [13]. We have demonstrated that insulin, through its signaling pathways in the endothelium, facilitates its own movement across the endothelial cells [15]. Very recently, we reported that eNOS and its activity play a critical role in regulation of insulin uptake and TET as inhibition of eNOS activity completely eliminates endothelial insulin uptake and TET [16]. Next critical question we would ask is how insulin intracellular signaling stimulates and coordinates the assembling of the molecular machinery for insulin trans-endothelial transport? A study just published by us has provided a clue to this puzzle, i.e. insulin stimulated caveolin-1 tyrosine 14 phosphorylation severs a trigger to possibly initiate insulin TET [19].

胰岛素要对肌肉、脂肪等外周组织的靶细胞发挥生物学作用，必须通过内皮屏障进入间质。胰岛素的经内皮转运(transendothelial transport, TET)，特别是在毛细血管内衬连续内皮的肌肉中，决定了组织胰岛素水平，从而关键地决定了胰岛素的代谢作用[1-6]。这一过程在胰岛素抵抗状态(如肥胖和2型糖尿病)中明显受损[2,7-9]。我们和其他人目前获得的证据表明，胰岛素TET是一个跨细胞过程，通过运输含有或与多种结构和信号分子相关的小泡介导，包括胰岛素受体(IR)、igf -1受体、小泡蛋白-1、动力蛋白-2、肌动蛋白丝和eNOS[10-18]。在这些成分中，caveolae及其关键结构蛋白caveolin-1已被证明是组织介导胰岛素TET的分子转胞机制的中心[13]。我们已经证明，胰岛素通过其在内皮中的信号通路，促进其自身在内皮细胞中的运动[15]。最近，我们报道了eNOS及其活性在调节胰岛素摄取和TET中起关键作用，因为抑制eNOS活性完全消除内皮胰岛素摄取和TET[16]。我们要问的下一个关键问题是胰岛素细胞内信号是如何刺激和协调胰岛素跨内皮转运的分子机制组装的?我们刚刚发表的一项研究为这个谜题提供了线索，即胰岛素刺激的小窝蛋白-1酪氨酸14磷酸化可能会触发胰岛素TET[19]。

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引用次数: 0

Hypertriglyceridemia Masking Hyperglycemia 高甘油三酯血症掩盖高血糖

Journal of metabolic syndrome

Pub Date : 2015-03-27 DOI: 10.4172/2167-0943.1000I101

Ria Ramadoo, Ryan Kunjal, Surujpal Teeluck singh

A 42 year old female diabetic poorly compliant to therapy presented with left facial pain and classic osmotic symptoms of hyperglycemia Clinical findings revealed dehydration and the features of a lower motor neuron lesion of the left facial nerve. Blood glucose measured by bedside glucose reflectance device ( TRUEresult ®) was 460 mg/dl compared with a value of 1280 mg/dl obtained on an identically timed specimen but measured by spectrophotometry (Figure 1). Plasma was noted to be markedly lipemic (Figure 2). and plasma triglyceride level was 9460 mg/dl. Glycemic control was achieved over several days with intensive insulin therapy. As plasma became less lipemic, the disparity between bedside and laboratory-derived values diminished steadily, eventually becoming identical. Blood glucose reflectance devices have revolutionized the management of diabetes but are unreliable when plasma is lipemic [1].

一位42岁女性糖尿病患者表现为左面部疼痛和典型的高血糖渗透症状，治疗依从性差。临床表现为左侧面神经脱水和下运动神经元病变。床边葡萄糖反射装置(TRUEresult®)测得的血糖值为460 mg/dl，而在同一时间的样品上用分光光度法测得的血糖值为1280 mg/dl(图1)。血浆中发现明显的脂血症(图2)，血浆甘油三酯水平为9460 mg/dl。经过几天的强化胰岛素治疗，血糖得到了控制。随着血浆中的脂质含量减少，床边和实验室得出的数值之间的差异稳步缩小，最终趋于一致。血糖反射装置已经彻底改变了糖尿病的治疗，但当血浆是血脂性血时，它是不可靠的。

引用次数: 0

The Cutoff Values of Visceral Fat in Metabolic Syndrome: Evidence fromStudies 代谢综合征中内脏脂肪的临界值:来自研究的证据

Journal of metabolic syndrome

Pub Date : 2015-02-28 DOI: 10.4172/2167-0943.1000E113

L. Roever, F. Veloso, E. Resende

Metabolic syndrome (MetS) is associated with abdominal obesity, blood lipid disorders, inflammation, insulin resistance, diabetes, and increased risk of developing cardiovascular disease and death. Visceral fat (VF) is a risk factor for multiple CVD risk factors, including endothelial dysfunction, hypertension, dyslipidemia, diabetes, impaired glucose metabolism, insulin resistance), liver insulin resistance, non-alcoholic fatty liver disease, sleep apnea. Visceral obesity is associated with higher occurrence of cardiovascular events [1-6].

代谢综合征(MetS)与腹部肥胖、血脂紊乱、炎症、胰岛素抵抗、糖尿病以及心血管疾病和死亡风险增加有关。内脏脂肪(VF)是多种CVD危险因素的危险因素，包括内皮功能障碍、高血压、血脂异常、糖尿病、糖代谢受损、胰岛素抵抗、肝脏胰岛素抵抗、非酒精性脂肪肝、睡眠呼吸暂停。内脏型肥胖与较高的心血管事件发生率相关[1-6]。

引用次数: 2

White Coat Hypertension is a Pioneer Sign of Metabolic Syndrome 白大衣高血压是代谢综合征的先兆

Journal of metabolic syndrome

Pub Date : 2015-01-10 DOI: 10.4172/2167-0943.1000172

M. Helvaci, Alihan Ozcan

Metabolic syndrome is an accelerated systemic atherosclerotic process terminating with obesity, hypertension, diabetes mellitus, peripheric artery disease, chronic renal disease, chronic obstructive pulmonary disease, cirrhosis, coronary heart disease, stroke, and eventually early aging and death. It shows itself with some reversible components including smoking, overweight, hyperbetalipoproteinemia, hypertriglyceridemia, dyslipidemia, impaired fasting glucose, impaired glucose tolerance, and white coat hypertension (WCH). The terminal consequences are probably due to the smoking and excess weight induced chronic inflammatory process on the endothelial system for a long period of time. WCH is a pioneer sign of the accelerated systemic atherosclerotic process that can be detected easily, and treated by preventing weight gain.

代谢综合征是一种加速的全身性动脉粥样硬化过程，以肥胖、高血压、糖尿病、外周动脉疾病、慢性肾病、慢性阻塞性肺疾病、肝硬化、冠心病、中风，最终早衰和死亡而告终。它表现为一些可逆的成分，包括吸烟、超重、高β -脂蛋白血症、高甘油三酯血症、血脂异常、空腹血糖受损、糖耐量受损和白大衣高血压(WCH)。其终末后果可能是由于吸烟和超重长期引起内皮系统的慢性炎症过程。WCH是系统性动脉粥样硬化过程加速的先兆，可以很容易地检测到，并通过防止体重增加来治疗。

引用次数: 7

Development and Validation of Metabolic Syndrome Prediction and Classification-Pathways using Decision Trees 使用决策树的代谢综合征预测和分类途径的发展和验证

Journal of metabolic syndrome

Pub Date : 2015-01-10 DOI: 10.4172/2167-0943.1000173

Brian Miller, M. Fridline

Purpose: The purpose of the current investigation was to create, compare, and validate sex-specific decision tree models to classify metabolic syndrome. Methods: Sex-specific Chi-Squared Automatic Interaction Detection, Exhaustive Chi-Squared Automatic Interaction Detection, and Classification and Regression Tree algorithms were run in duplicate using metabolic syndrome classification criteria, subject characteristics, and cardiovascular predictor variable from the National Health and Nutrition Examination Survey cohort data. Data from 1999-2012 were used (n=10,639; 1999-2010 cohorts for model creation and 2011-2012 cohort for model validation). Metabolic Syndrome was classified as the presence of 3 of 5 American Heart Association National Heart Lung and Blood Institute Metabolic Syndrome classification criteria. The first run was made with all predictor variables and the second run was made excluding metabolic syndrome classification predictor variables. Given that the included decision tree algorithms are non-parametric procedures, all decision tree models were compared to a logistic regression based model to provide a parametric comparison. Results: The Classification and Regression Tree algorithm outperformed all other decision tree models and logistic regression with a specificity of 0.908 and 0.952, sensitivity of 0.896 and 0.848, and misclassification error of 0.096 and 0.080 for males and females, respectively. Only one predictor variable outside of the metabolic syndrome classification reached significance in the female model (age). All metabolic syndrome classification predictor variables reached significance in the male model. Waist circumference did not reach significance in the female model. Within each model, 5 female and 3 male pathways built off of <3 American Heart Association National Heart Lung and Blood Institute Metabolic Syndrome classification criteria resulted in an increased likelihood of presenting Metabolic Syndrome. Conclusion: The proposed pathways show promise over other current metabolic syndrome classification models in identifying Metabolic Syndrome with <3 predictor variables, before current classification criteria.

目的:当前研究的目的是创建、比较和验证性别特异性决策树模型，以对代谢综合征进行分类。方法:使用代谢综合征分类标准、受试者特征和来自全国健康与营养检查队列数据的心血管预测变量，对性别特异性卡方自动交互检测、穷举式卡方自动交互检测以及分类和回归树算法进行重复运行。使用1999-2012年的数据(n=10,639;1999-2010年的队列用于模型创建，2011-2012年的队列用于模型验证)。代谢综合征被归类为存在美国心脏协会国家心肺血液研究所代谢综合征分类标准中的3个。第一次运行使用所有预测变量，第二次运行排除代谢综合征分类预测变量。考虑到所包含的决策树算法是非参数过程，将所有决策树模型与基于逻辑回归的模型进行比较，以提供参数比较。结果:分类回归树算法的特异性分别为0.908和0.952，敏感性分别为0.896和0.848，男性和女性的误分类误差分别为0.096和0.080，优于其他决策树模型和逻辑回归。在女性模型中，除了代谢综合征分类外，只有一个预测变量(年龄)具有显著性。所有代谢综合征分类预测变量在男性模型中均达到显著性。女性模特的腰围没有达到显著性。在每个模型中，根据<3美国心脏协会国家心肺和血液研究所代谢综合征分类标准建立的5个女性和3个男性途径导致出现代谢综合征的可能性增加。结论:在目前的分类标准之前，所提出的途径在识别具有<3个预测变量的代谢综合征方面比其他现有的代谢综合征分类模型更有希望。

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引用次数: 8

Metabolic Disorders in HIV-infected Children Metabolic Disorders in HIVinfectedChildren 艾滋病毒感染儿童的代谢紊乱

Journal of metabolic syndrome

Pub Date : 2014-11-26 DOI: 10.4172/2167-0943.1000169

Spagnuolo Mi, I. Liguoro, A. Guarino

The introduction of highly active antiretroviral therapy (HAART) for the treatment of acquired immunodeficiency syndrome (AIDS) has resulted in greater survival of patients infected with the human immunodeficiency virus (HIV). However, the use of these drugs has been associated with lipodystrophic syndrome (LS), which is characterized by metabolic alterations (dyslipidemia, insulin resistance, diabetes, and lactic acidosis) and abnormal corporal fat distribution. Clinically, LS may manifest as three different forms: lipohypertrophy (accumulation of fat in the central part of the body), lipoatrophy (loss of fat in the extremities, face and buttocks) and mixed (lipohypertrophy + lipoatrophy). Although its physiopathology has not been elucidated, some mechanisms have been described, including leptin and adiponectin deficiency, mitochondrial dysfunction and use of antiretroviral drugs. The type, dose and duration of the antiretroviral treatment, as well as age and puberty are the main risk factors. LS are also associated with increased incidence of cardiovascular illnesses, atherosclerosis and diabetes mellitus. Follow up must be periodic, consisting of measurement of body fat distribution, evaluation of the lipid profile and insulin resistance.

采用高效抗逆转录病毒疗法(HAART)治疗获得性免疫缺陷综合症(艾滋病)，提高了感染人类免疫缺陷病毒(艾滋病毒)的患者的存活率。然而，这些药物的使用与脂肪营养不良综合征(LS)有关，其特征是代谢改变(血脂异常、胰岛素抵抗、糖尿病和乳酸性酸中毒)和身体脂肪分布异常。临床上，LS可表现为脂肪肥大(身体中部脂肪堆积)、脂肪萎缩(四肢、面部和臀部脂肪减少)和混合型(脂肪肥大+脂肪萎缩)三种不同的形式。虽然其生理病理尚未阐明，但一些机制已被描述，包括瘦素和脂联素缺乏，线粒体功能障碍和使用抗逆转录病毒药物。抗逆转录病毒治疗的类型、剂量和持续时间，以及年龄和青春期是主要的危险因素。LS还与心血管疾病、动脉粥样硬化和糖尿病的发病率增加有关。随访必须定期进行，包括测量体脂分布，评估血脂和胰岛素抵抗。

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引用次数: 2

Effects of Malaria on Iron Stores in the Pregnant Women of Buea and Tiko Health District, South West Region, Cameroon 疟疾对喀麦隆西南地区Buea和Tiko卫生区孕妇铁储备的影响

Journal of metabolic syndrome

Pub Date : 2014-11-26 DOI: 10.4172/2167-0943.1000170

N. O. Nlinwe

Malaria infection has a complex effect on iron metabolism that may affect the interpretation of haemoglobin, serum ferritin, serum transferrin and serum iron. The main objective of this study was to determine the effect of malaria parasitaemia on the iron store forms of pregnant women in the Buea and Tiko health districts of the S.W Region of Cameroon. This investigation was carried out from the 3rd of August 2011 to the 30th of April 2012. The non-probabilistic sampling method was used to recruit a total of 377 pregnant women into the study. Questionnaires were used for the collection of secondary data. The microscopy method was used to detect the presence of malaria infection. A total of 41.4% (156/377) of the pregnant women were infected with Plasmodium falciparum. Of the infected cases; 32.1% had low levels of serum ferritin ( 360 mg/dl), and 45.5% had low levels of serum iron (<9.0 μmol/l). The quantitative results using regression analysis justified that 88% variation in serum ferritin, transferrin and iron were accounted for by variation in malaria parasitaemia during the second and the third trimesters. Serum iron, ferritin and transferrin measurements should be incorporated as one of the routine laboratory tests during the regular antenatal care visits.

疟疾感染对铁代谢有复杂的影响，可能影响血红蛋白、血清铁蛋白、血清转铁蛋白和血清铁的解释。这项研究的主要目的是确定疟疾寄生虫病对喀麦隆西南地区Buea和Tiko卫生区孕妇铁储存形式的影响。本次调查于2011年8月3日至2012年4月30日进行。采用非概率抽样方法，共招募377名孕妇参与研究。调查问卷用于收集辅助数据。显微镜法检测疟疾感染的存在。孕妇感染恶性疟原虫的比例为41.4%(156/377)。在感染病例中;32.1%的患者血清铁蛋白水平低(360 mg/dl)， 45.5%的患者血清铁水平低(<9.0 μmol/l)。采用回归分析的定量结果证明，血清铁蛋白、转铁蛋白和铁含量的变化88%是由妊娠中期和晚期疟疾寄生虫病的变化引起的。血清铁、铁蛋白和转铁蛋白的测定应作为常规产前检查的常规实验室检查之一。

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引用次数: 3

Bioimpedance Evaluation of Body Fat Composition in Congolese HIV-Infected Patients under Antiretroviral Therapy Regimen Non-Containing Protease Inhibitors nor Stavudine 不含蛋白酶抑制剂和司他夫定的抗逆转录病毒治疗方案下刚果hiv感染者体脂肪组成的生物阻抗评价

Journal of metabolic syndrome

Pub Date : 2014-11-10 DOI: 10.4172/2167-0943.1000168

J. Makulo, Djuma Lukonga, A. Longo, Jean De Dieu Manyebwa, Trésor Monsere, E. Sumaili, H. Situakibanza, J. B. Kasiam, R. Mbungu, J. Kayembe, F. Lepira

Background: Protease inhibitors (PI) and stavudine are frequently associated with abnormalities of the body composition. The present study aimed to evaluate the body fat composition of HIV-infected Congolese patients receiving antiretroviral other than PI or stavudine. Patients and Methods: Anthropometric measures and body composition of 125 HIV-infected Congolese patients (average age 41 years, 76% women, 74% on antiretroviral therapy) attending a primary healthcare center was cross-sectionally evaluated. Patients receiving PI and/or stavudine were excluded. Subclinical abnormalities of body composition, evaluated by bioimpedance (BIA), were defined as elevated percentage of fat mass (FM) and perivisceral fat mass (PVF) and low percentage of total FM. Results: Clinically evaluated abnormalities of fat distribution were rarely seen, with any case of obesity or lipodystrophy. Overweight (16%) and central obesity (6.3%) were present only in a few women. BIA parameters of body fat composition were similar among antiretroviral naive and treated patients. An average higher percentage of FM (28% vs. 12.1%; p<0.001) and PVF (4.0% vs. 2.3%; p=0.002) were observed in women, with as well as a higher proportion of subjects with high levels of FM (12.6%) and PVF (2.2%) in the same group. Thinness was observed only in 6% of patients of whom 83.3% of men and 68.4% of women (p=0.059) had low levels of FM. Conclusion: Subclinical abnormalities of FM were present in these case series without clinically overt fat distribution abnormalities, highlighting the need for early detection of these FM abnormalities.

背景:蛋白酶抑制剂(PI)和司他夫定经常与身体成分异常有关。本研究旨在评估接受非PI或司他夫定抗逆转录病毒治疗的刚果艾滋病毒感染患者的体脂组成。患者和方法:对在初级卫生保健中心就诊的125名感染艾滋病毒的刚果患者(平均年龄41岁，76%为女性，74%接受抗逆转录病毒治疗)的人体测量测量和身体成分进行了横断面评估。排除了接受PI和/或司他夫定的患者。身体组成的亚临床异常，通过生物阻抗(BIA)评估，被定义为脂肪量(FM)和内脏周围脂肪量(PVF)百分比升高，总脂肪量百分比低。结果:临床评价的脂肪分布异常少见，无肥胖或脂肪营养不良病例。超重(16%)和中心性肥胖(6.3%)仅出现在少数女性中。未接受抗逆转录病毒治疗和治疗的患者体脂组成BIA参数相似。FM的平均比例更高(28% vs. 12.1%;p<0.001)和PVF (4.0% vs. 2.3%;p=0.002)，在同一组中，高水平FM(12.6%)和PVF(2.2%)的比例更高。只有6%的患者消瘦，其中83.3%的男性和68.4%的女性(p=0.059)有低水平的FM。结论:在这些病例系列中存在亚临床的FM异常，但没有临床明显的脂肪分布异常，强调了早期发现这些FM异常的必要性。

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引用次数: 1

Low Hepatic Mg²⁺ Content promotes Liver dysmetabolism: Implications for the Metabolic Syndrome. 肝脏 Mg2+ 含量低促进肝脏代谢紊乱：对代谢综合征的影响

Journal of metabolic syndrome

Pub Date : 2014-10-01 DOI: 10.4172/2167-0943.1000165

Chesinta Voma, Zienab Etwebi, Danial Amir Soltani, Colleen Croniger, Andrea Romani

Metabolic Syndrome, a pathological condition affecting approximately 35% of the USA population, is characterized by obesity, insulin resistance, and hypertension. Metabolic syndrome is considered the single most common condition predisposing to the development of various chronic diseases including diabetes and hypertension. Hypomagnesaemia has been consistently observed in association with metabolic syndrome, but it is unclear whether reduced Mg²⁺ levels are the consequence or a possible cause for the development of the metabolic syndrome and/or its associated pathologies. Research performed in our laboratory showed that rats exposed for 2 weeks to a Mg²⁺ deficient diet presented decreased glucose accumulation into the hepatocytes together with low Mg²⁺ level in the circulation and within the liver cells. To better investigate the changes in glucose metabolism, HepG2 were used to mimic in vitro Mg²⁺ deficiency conditions. HepG2 cells cultured in low extracellular Mg²⁺ presented a 20% decrease in total cellular Mg²⁺ content, reduced glucose accumulation, and enhanced glucose 6-phosphate (G6P) transport into the endoplasmic reticulum (ER). The increased G6P transport was associated with its enhanced hydrolysis by the glucose 6-phosphatase, but also conversion to 6-phosphogluconolactone by the glucose 6-phosphate dehydrogenase. The latter process resulted in the increased generation of NADPH within the ER and the increased conversion of cortisone to cortisol by the 11-β-hydroxysteroid dehydrogenase type-1 (11-β-OHSD1). Taken together, our results provide compelling evidence that Mg²⁺ deficiency precedes and actually promotes some of the hepatic dysmetabolisms typical of the metabolic syndrome. The decrease in intrahepatic Mg²⁺ content up-regulates G6P entry into the hepatic endoplasmic reticulum and its routing into the pentose shunt pathway for energetic purposes. The associated increased in NADPH production within the ER then stimulates cortisol production, setting the conditions for hepatic insulin resistance and further altering liver metabolism.

代谢综合征是一种病理状态，影响着约 35% 的美国人口，其特征是肥胖、胰岛素抵抗和高血压。代谢综合征被认为是导致包括糖尿病和高血压在内的各种慢性疾病的最常见病因。低镁血症一直被认为与代谢综合征有关，但目前还不清楚 Mg2+ 水平降低是代谢综合征和/或其相关病症发生的结果还是可能的原因。我们实验室进行的研究表明，大鼠在连续两周摄入缺乏 Mg2+ 的饮食后，肝细胞内的葡萄糖积累减少，同时血液循环和肝细胞内的 Mg2+ 含量降低。为了更好地研究葡萄糖代谢的变化，研究人员使用 HepG2 来模拟体外 Mg2+ 缺乏的条件。在低细胞外 Mg2+ 条件下培养的 HepG2 细胞，其细胞总 Mg2+ 含量下降了 20%，葡萄糖积累减少，进入内质网（ER）的 6-磷酸葡萄糖（G6P）转运增强。G6P 转运的增加与葡萄糖 6-磷酸酶水解作用的增强有关，但也与葡萄糖 6-磷酸脱氢酶将 G6P 转化为 6-磷酸葡萄糖酸内酯有关。后一过程增加了 ER 内 NADPH 的生成，并增加了 11-β- 羟基类固醇脱氢酶-1 型（11-β-OHSD1）将可的松转化为可的松的过程。总之，我们的研究结果提供了令人信服的证据，证明 Mg2+ 缺乏先于并实际上促进了代谢综合征典型的肝脏代谢紊乱。肝内 Mg2+ 含量的减少会上调 G6P 进入肝脏内质网的速度，并使其进入戊糖分流途径以获得能量。随之而来的内质网中 NADPH 生成的增加刺激了皮质醇的生成，为肝脏胰岛素抵抗创造了条件，并进一步改变了肝脏的新陈代谢。

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引用次数: 0