Metabolic disturbances in diabetic cardiomyopathy

摘要: It has been established that diabetes results in a cardiomyopathy, and increasing evidence suggests an altered substrate supply utilization by cardiac myocytes could be the primary injury pathogenesis of this specific heart muscle disease. For example, diabetes, glucose is insignificant, energy production shifted almost exclusively towards β-oxidation free fatty acids (FFA). FFA’s are supplied to cells from two sources: lipolysis endogenous triglyceride (TG) stores, or exogenous sources blood (as acid bound albumin as TG lipoproteins). The approximate contribution FFA diabetic unknown. In insulin-deficient state, adipose tissue enhanced, resulting elevated circulating FFA. addition, hydrolysis augmented myocardial stores also lead high Whatever source FFA, their increased may have deleterious effects on function includes abnormally oxygen requirement during metabolism, intracellular accumulation potentially toxic intermediates FFA-induced inhibition oxidation, severe morphological changes. Therapies target these metabolic aberrations early stages delay impede progression more permanent sequelae ensue otherwise uncontrolled derangements metabolism. (Mol Cell Biochem 180: 53–57, 1998)