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Las lipoproteínas de alta densidad modulan el metabolismo de la glucosa en pacientes con diabetes mellitus tipo 2
Brian G Drew1, Stephen J Duffy, Melissa F Formosa
1Baker IDI Heart and Diabetes Institute, Melbourne, Australia.
Circulation
|April 8, 2009
Resumen
La lipoproteína de alta densidad reconstituida (HDL) reduce la glucosa en sangre en la diabetes tipo 2 al aumentar la insulina y activar la proteína quinasa activada por AMP en el músculo. Esto sugiere que las terapias HDL pueden tratar la diabetes tipo 2 más allá de los beneficios cardiovasculares.
Área de la Ciencia:
- El síndrome metabólico.
- Riesgo cardiovascular El riesgo cardiovascular.
- Metabolismo de la glucosa El metabolismo de la glucosa.
Sus antecedentes:
- La lipoproteína de baja alta densidad (HDL) está relacionada con un mayor riesgo cardiovascular y el síndrome metabólico.
- Se investigó el papel del HDL en la modulación del metabolismo de la glucosa a través de la insulina y la proteína quinasa activada por AMP (AMPK) en el músculo esquelético.
Objetivo del estudio:
- Para investigar el efecto del HDL reconstituido (rHDL) en el metabolismo de la glucosa en pacientes con diabetes mellitus tipo 2.
- Para determinar si rHDL activa la proteína quinasa activada por AMP (AMPK) en el músculo esquelético.
Principales métodos:
- Un estudio cruzado doble ciego, controlado con placebo, en el que participaron 13 pacientes con diabetes mellitus tipo 2.
- La administración intravenosa de rHDL (80 mg/kg) o el placebo.
- Medición de la glucosa plasmática, la insulina y la activación de la vía AMPK (fosforilación beta de la carboxilasa acetil-CoA) en las biopsias del músculo esquelético.
- Evaluación de la absorción de glucosa en cultivos de células de músculo esquelético humano.
Principales resultados:
- rHDL redujo significativamente la glucosa plasmática en comparación con el placebo.
- rHDL aumentó la insulina plasmática y el modelo de homeostasis evaluó el índice de función de las células beta.
- rHDL activó la vía de la proteína quinasa activada por AMP (AMPK) en el músculo esquelético.
- El HDL y la apolipoproteína AI aumentaron la absorción de glucosa en las células del músculo esquelético humano.
Conclusiones:
- rHDL reduce efectivamente la glucosa plasmática en pacientes con diabetes tipo 2 al mejorar la secreción de insulina y activar la AMPK en el músculo esquelético.
- Las terapias que aumentan el HDL muestran potencial para el tratamiento de la diabetes tipo 2, que se extiende más allá de su papel establecido en el manejo de la aterosclerosis.
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