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中华脑血管病杂志(电子版) ›› 2022, Vol. 16 ›› Issue (02) : 120 -124. doi: 10.11817/j.issn.1673-9248.2022.02.011

综述

胰岛素抵抗与缺血性脑卒中关系的研究进展
梁俏丽1, 陈静娟1, 周锋1, 邵燕2, 王玉凯2, 章成国1,()   
  1. 1. 528000 广东省佛山市第一人民医院神经内科
    2. 510000 广州,中山大学孙逸仙纪念医院神经内科
  • 收稿日期:2022-03-01 出版日期:2022-04-01
  • 通信作者: 章成国
  • 基金资助:
    登峰计划-依托互联网+大数据平台构建佛一卒中中心精准防治体系(2020A022)

Research progress in the association between insulin resistance and ischemic stroke

Qiaoli Liang1, Jingjuan Chen1, Feng Zhou1, Yan Shao2, Yukai Wang2, Chengguo Zhang1,()   

  1. 1. Department of Neurology, the First People's Hospital of FoShan, FoShan 528000, China
    2. Department of Neurology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou 510000, china
  • Received:2022-03-01 Published:2022-04-01
  • Corresponding author: Chengguo Zhang
引用本文:

梁俏丽, 陈静娟, 周锋, 邵燕, 王玉凯, 章成国. 胰岛素抵抗与缺血性脑卒中关系的研究进展[J/OL]. 中华脑血管病杂志(电子版), 2022, 16(02): 120-124.

Qiaoli Liang, Jingjuan Chen, Feng Zhou, Yan Shao, Yukai Wang, Chengguo Zhang. Research progress in the association between insulin resistance and ischemic stroke[J/OL]. Chinese Journal of Cerebrovascular Diseases(Electronic Edition), 2022, 16(02): 120-124.

胰岛素抵抗是胰岛素介导的组织中葡萄糖代谢控制的缺陷,与血糖、脂肪、能量代谢及神经调节密切相关,可通过炎症、氧化应激、损伤内皮细胞及促进神经元凋亡导致动脉粥样硬化,减少细胞灌注等途径引起神经元的损伤、凋亡,从而导致缺血性脑卒中及认知功能障碍等事件的发生。新近药物研究发现改善胰岛素抵抗从而降低心脑血管事件发生风险已成为医学界日益关注的议题。钠-葡萄糖协同转运蛋白-2抑制剂恩格列净通过调节下丘脑对胰岛素反应,可增加大脑的胰岛素敏感性,有望成为新的治疗靶点,预防或延缓缺血性脑卒中;新上市的胰岛素增敏剂能同时调节血糖和血脂代谢,改善代谢综合征,在脑卒中预防与治疗中有广阔的应用前景。

Insulin resistance is an impaired insulin-mediated condition of glucose metabolism control, which is closely related with blood sugar, fat and energy metabolism and nervous regulation. It can result in inflammation, oxidative stress, endothelium damage, and neuronal apoptosis which brings about atherosclerosis. In addition, it can cause hypoperfusion causing neuron damage and apoptosis, which eventually leads to ischemic stroke and cognitive dysfunction. Recently, pharmacological findings that improving insulin resistance can reduce the risk of cardiovascular and cerebrovascular events, have become a growing field in the medical academy. Sodium-dependent glucose transporters-2 inhibitor Empagliflozin, which increases the insulin sensitivity in the brain by regulating hypothalamus response to insulin, is expected to become a new therapeutic approach to prevent or delay ischemic stroke. The newly-listed insulin sensitizer can simultaneously regulate the metabolism of blood glucose and blood lipids , improve the metabolic syndrome, and has a promising application in the prevention and treatment of stroke.

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