Obezite, Tip 2 Diyabet ve İnsülin Direnci Arasındaki Bağlantı: İnflamasyon
Tip 2 Diabetes Mellitus (T2DM), obezite ve fiziksel inaktiviteye bağlı olarak sıklıkla gözlemlenen,periferik dokularda insülin direnci ve pankreatik β hücresi disfonksiyonu ile karakterize olankronik metabolik bir hastalıktır. İnsülin direnci, pankreas tarafından salgılanan insülinin yağ,kas ve karaciğer hücrelerinde gerekli veya yeterli tepkiyi oluşturamaması durumudur. Obezite,sıklıkla insülin direnci ve T2DM’nin de eşlik ettiği yağ dokunun aşırı artışıyla karakterizemetabolik bir hastalıktır. Yağ doku nedenli inflamasyon da, obezite ve insülin direncini birbirinebağlar ve böylece T2DM’nin erken evresinde anahtar rol oynar. İnflamasyon, immün sistemindoğal bir bileşeni olup, her türlü zararlı, yabancı ve yıkıcı etkene karşı organizmanın verdiğidoğal savunma yanıtıdır. Ancak inflamasyon, kişinin kendi dokularına karşı geliştiğinde,yeterince kontrol edilemediği durumlarda veya kronik inflamasyon geliştiğinde diyabet, obeziteve kanserin de içinde bulunduğu çeşitli patolojiler ortaya çıkmaktadır. İnflamasyon mekanizması;interlökinler, interferonlar, TNF-α, MAP-kinazlar, Toll-like reseptörler, NF-kB gibi kemokin,kemokin reseptörleri ve sitokinlerden oluşan çok sayıda anahtar düzenleyiciyi içerir.İnflamasyonun, insülin direnci üzerine olan önemli etkisi bilinmekle birlikte günümüzdeinflamasyonun T2DM ve obezite üzerine etkisi henüz aydınlatılamamıştır. Derlememizdeinsülin direnci, obezite, T2DM hastalıklarının inflamasyonla ilişkisi incelenecek ve inflamatuvarsüreçte görev alan temel genler ayrıntılı olarak ele alınacaktır.
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