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La tormentosa relación entre las grasas y el desarrollo de la diabetes mellitus tipo 2: actualizado. Parte 2

Published on Jul 1, 2017in Revista Argentina de Endocrinología y Metabolismo
· DOI :10.1016/j.raem.2017.06.002
José Esteban Costa Gil , Eduardo Spinedi (Facultad de Ciencias Médicas)
Abstract
Resumen En esta parte de la revision se describe la relacion funcional entre el metabolismo de los lipidos y los hidratos de carbono y su interdependencia, desde el ciclo glucosa-acido grasos y la hipotesis portal de la insulinorresistencia a los nuevos conocimientos sobre los adipocitos marrones y beiges, con enfasis en el normal funcionamiento de un patron endocrino cuya disfuncion es clave en la fisiopatologia de la DMT2 y la obesidad. Se discute la ectopia o el asiento de grasa en el tejido magro por incapacidad del tejido adiposo para seguir acopiando lipidos y la actividad endocrina del adipocito , con la produccion de moleculas (adipoquinas) que influyen sobre los mecanismos inductores de insulinorresistencia (leptina, adiponectina, TNF-α, resistina, etc.) y disfuncion de la celula beta. Se describen la disminucion de la capacidad oxidativa en la cadena respiratoria mitocondrial y el renacer del concepto de lipogenesis de novo , ambas favoreciendo el acopie de lipido intracelular. En tejidos magros existen pequenas reservas intracelulares de lipidos que mantienen la regulacion de funciones esenciales, aunque si aparece una sobrecarga lipidica el fenomeno conduciria a una disfuncion (lipotoxicidad) y a la muerte celular (lipoapoptosis). La tormentosa relacion entre los lipidos y el islote de Langerhans va mas alla del esfuerzo funcional que impone la insulinorresistencia periferica sobre la celula β, por efectos directos de los lipidos o de sus derivados sobre la funcion del islote pancreatico. Sin deficit de insulina no se desarrolla diabetes.
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Chih‐Hao Wang3
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Estimated H-index: 61
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