Lipid composition of cell membranes and its relevance in type 2 diabetes mellitus.
Identifying the causative relationship between the fatty acid composition of cell membranes and type 2 diabetes mellitus fundamentally contributes to the understanding of the basic pathophysiological mechanisms of the disease. Important outcomes of the reviewed studies appear to support the hypotheses that the flexibility of a membrane determined by the ratio of (poly)unsaturated to saturated fatty acyl chains of its phospholipids influences the effectiveness of glucose transport by insulin-independent glucose transporters (GLUTs) and the insulin-dependent GLUT4, and from the prediabetic stage on a shift from unsaturated towards saturated fatty acyl chains of membrane phospholipids directly induces a decrease in glucose effectiveness and insulin sensitivity. In addition, it has become evident that a concomitant increase in stiffness of both plasma and erythrocyte membranes may decrease the microcirculatory flow, leading ultimately to tissue hypoxia, insufficient tissue nutrition, and diabetes-specific microvascular pathology. As to the etiology of type 2 diabetes mellitus, a revised hypothesis that attempts to accommodate the reviewed findings is presented.
Teaching Hospital, Onze Lieve Vrouwe Gasthuis, Oosterparkstraat 9, PO Box 95500, 1090 HM Amsterdam, The Netherlands. robw01@xs4all.nl
Rob N M
RN
Weijers
D001692:Biological Transport; D001786:Blood Glucose / Q000378:metabolism; D002462:Cell Membrane / Q000737:chemistry*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood*; D004910:Erythrocyte Membrane / Q000737:chemistry; D005227:Fatty Acids / Q000097:blood; D005231:Fatty Acids, Unsaturated / Q000097:blood; D051275:Glucose Transporter Type 4 / Q000097:blood*; D006801:Humans; D007333:Insulin Resistance; D008055:Lipids / Q000097:blood*; D008833:Microcirculation; D010743:Phospholipids / Q000097:blood; D011236:Prediabetic State / Q000097:blood*
D001786:Blood Glucose; D005227:Fatty Acids; D005231:Fatty Acids, Unsaturated; D051275:Glucose Transporter Type 4; D008055:Lipids; D010743:Phospholipids