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Insulin resistance of amino acid and protein metabolism in type 2 diabetes

Summary Although insulin resistance in T2DM (type 2 diabetes mellitus) is usually referred to glucose and lipid metabolism, the question whether such a resistance affects also amino acid and protein metabolism is both relevant and not easy to be answered. Available data indicate a reduced response t...

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Published in:Clinical nutrition (Edinburgh, Scotland) Scotland), 2011-06, Vol.30 (3), p.267-272
Main Authors: Tessari, Paolo, Cecchet, Diego, Cosma, Alessandra, Puricelli, Lucia, Millioni, Renato, Vedovato, Monica, Tiengo, Antonio
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description Summary Although insulin resistance in T2DM (type 2 diabetes mellitus) is usually referred to glucose and lipid metabolism, the question whether such a resistance affects also amino acid and protein metabolism is both relevant and not easy to be answered. Available data indicate a reduced response to insulin in the inhibition of proteolysis at low, near basal hormone levels, whereas such a response appears to be normal at high physiological doses. In most studies in T2DM subjects the stimulation of whole-body protein synthesis in the presence of hyperinsulinemia and euaminoacidemia appears to be normal, although one single study reported lower rates in male T2DM subjects with obesity. The response to insulin of plasma protein synthesis (albumin and fibrinogen) is also normal. However, some metabolic steps of amino acids related to vascular complications (methionine and arginine) exhibit a defective response to insulin in T2DM subjects with nephropathy. In summary, although gross alterations in the response of whole-body protein turnover are not evident in T2DM, specific investigations reveal subtle abnormalities in metabolic steps of selected amino acids. Furthermore, the effects of interaction between diabetes (with the associated insulin resistance) and older age in the pathogenesis of sarcopenia in the elderly deserve more specific studies.
doi_str_mv 10.1016/j.clnu.2011.02.009
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Available data indicate a reduced response to insulin in the inhibition of proteolysis at low, near basal hormone levels, whereas such a response appears to be normal at high physiological doses. In most studies in T2DM subjects the stimulation of whole-body protein synthesis in the presence of hyperinsulinemia and euaminoacidemia appears to be normal, although one single study reported lower rates in male T2DM subjects with obesity. The response to insulin of plasma protein synthesis (albumin and fibrinogen) is also normal. However, some metabolic steps of amino acids related to vascular complications (methionine and arginine) exhibit a defective response to insulin in T2DM subjects with nephropathy. In summary, although gross alterations in the response of whole-body protein turnover are not evident in T2DM, specific investigations reveal subtle abnormalities in metabolic steps of selected amino acids. 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subjects Amino Acids - metabolism
Animals
Biological and medical sciences
Diabetes Mellitus, Type 2
Diabetes. Impaired glucose tolerance
Dietary Proteins - metabolism
Endocrine pancreas. Apud cells (diseases)
Endocrinopathies
Etiopathogenesis. Screening. Investigations. Target tissue resistance
Feeding. Feeding behavior
Fundamental and applied biological sciences. Psychology
Gastroenterology and Hepatology
Humans
Insulin Resistance
Medical sciences
Methionine turnover
Nitric oxide synthesis
Protein Biosynthesis
Protein degradation
Protein synthesis
Type 2 diabetes
Vertebrates: anatomy and physiology, studies on body, several organs or systems
title Insulin resistance of amino acid and protein metabolism in type 2 diabetes
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