期刊
AMERICAN JOURNAL OF PHYSIOLOGY-HEART AND CIRCULATORY PHYSIOLOGY
卷 305, 期 12, 页码 H1693-H1697出版社
AMER PHYSIOLOGICAL SOC
DOI: 10.1152/ajpheart.00854.2012
关键词
insulin resistance; metabolism; obesity
资金
- National Heart, Lung, and Blood Institute [HL-061483]
- American Heart Association
- Belgian Fonds National de la Recherche Scientifique
Reversing impaired insulin sensitivity has been suggested as treatment for heart failure. However, recent clinical evidence suggests the opposite. Here we present a line of reasoning in support of the hypothesis that insulin resistance protects the heart from the consequences of fuel overload in the dysregulated metabolic state of obesity and diabetes. We discuss pathways of myocardial fuel toxicity, as well as several layers of defense against fuel overload. Our reassessment of the literature suggests that in the heart, insulin-sensitizing agents result in an elimination of some of the defenses, leading to cytotoxic damage. In contrast, a normalization of fuel supply should either prevent or reverse the process. Taken together, we offer a new perspective on insulin resistance of the heart.
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