Renal glucose metabolism in normal physiological conditions and in diabetes

被引:122
作者
Alsahli, Mazen [1 ,2 ]
Gerich, John E. [3 ]
机构
[1] Southlake Reg Hlth Ctr, Newmarket, ON, Canada
[2] Univ Toronto, Fac Med, Toronto, ON, Canada
[3] Univ Rochester, Sch Med, Rochester, NY USA
关键词
Glucose homeostasis; Glucose metabolism; Glucose physiology; Renal glucose metabolism; Glucose transporters; Sodium-glucose co-transporter 2; SGLT2; Diabetes mellitus; COTRANSPORTER; 2; INHIBITION; PROXIMAL TUBULAR CELLS; HEPATIC GLUCONEOGENESIS; SGLT2; INHIBITORS; PANCREATIC ALPHA; SKELETAL-MUSCLE; HUMAN KIDNEY; IN-VIVO; SODIUM; LIVER;
D O I
10.1016/j.diabres.2017.07.033
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
The kidney plays an important role in glucose homeostasis via gluconeogenesis, glucose utilization, and glucose reabsorption from the renal glomerular filtrate. After an overnight fast, 20-25% of glucose released into the circulation originates from the kidneys through gluconeogenesis. In this post-absorptive state, the kidneys utilize about 10% of all glucose utilized by the body. After glucose ingestion, renal gluconeogenesis increases and accounts for approximately 60% of endogenous glucose release in the postprandial period. Each day, the kidneys filter approximately 180 g of glucose and virtually all of this is reabsorbed into the circulation. Hormones (most importantly insulin and catecholamines), substrates, enzymes, and glucose transporters are some of the various factors influencing the kidney's role. Patients with type 2 diabetes have an increased renal glucose uptake and release in the fasting and the post-prandial states. Additionally, glucosuria in these patients does not occur at plasma glucose levels that would normally produce glucosuria in healthy individuals. The major abnormality of renal glucose metabolism in type 1 diabetes appears to be impaired renal glucose release during hypoglycemia. (C) 2017 Elsevier B.V. All rights reserved.
引用
收藏
页码:1 / 9
页数:9
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