J Lipid Atheroscler.  2020 Jan;9(1):92-109. 10.12997/jla.2020.9.1.92.

Positioning Metabolism as a Central Player in the Diabetic Heart

Affiliations
  • 1Department of Physiology, Anatomy and Genetics, University of Oxford, Oxford, UK. lisa.heather@dpag.ox.ac.uk

Abstract

In type 2 diabetes (T2D), the leading cause of death is cardiovascular complications. One mechanism contributing to cardiac pathogenesis is alterations in metabolism, with the diabetic heart exhibiting increased fatty acid oxidation and reduced glucose utilisation. The processes classically thought to underlie this metabolic shift include the Randle cycle and changes to gene expression. More recently, alternative mechanisms have been proposed, most notably, changes in post-translational modification of mitochondrial proteins in the heart. This increased understanding of how metabolism is altered in the diabetic heart has highlighted new therapeutic targets, with an aim to improve cardiac function in T2D. This review focuses on metabolism in the healthy heart and how this is modified in T2D, providing evidence for the mechanisms underlying this shift. There will be emphasis on the current treatments for the heart in diabetes, alongside efforts for metabocentric pharmacological therapies.

Keyword

Type 2 diabetes; Cardiac metabolism; Cardiovascular complications; Mitochondrial acetylation

MeSH Terms

Cause of Death
Gene Expression
Glucose
Heart*
Metabolism*
Mitochondrial Proteins
Protein Processing, Post-Translational
Glucose
Mitochondrial Proteins
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