Alvehus M, Buren J, Sjostrom M (2010) The human visceral fat depot has a unique inÏlammatory proÏile. Obesity 18(5): 879Ǧ883. 31. Samuel VT, Petersen KF, ...
Mini Review Volume 3 Issue 2 January 2018
OAJ Gerontol & Geriatric Med Copyright © All rights are reserved by Vinod Nikhra
The Altered Metabolic Homeostasis in Middle Aged and Elderly: Aging and Other Determinants of Insulin Secretion, Action and Resistance Vinod Nikhra*
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ǡ Submission: January 25, 2018; Published: January 31, 2018 *Corresponding author: Vinod Nikhra, Department of Medicine, Hindu Rao Hospital and NDMC Medical College, New Delhi, India, Email:
Abstract Metabolic Homeostasis and Aging:
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Visceral Fat, Aging and Insulin Action:
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Conclusion-Risk Factors for Altered Glucose Homeostasis: A multitude of factors lead to the somatic carbohydrate homeostatic
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Abbreviations: ǣ
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Introduction Homeostasis and Metabolism Homeostasis refers to the body’s ability to physiologically regulate its inner milieu and ensure its stability in response ϐ
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by which homeostasis operates, and in event of any disruption ǡ
Ǥ inability to maintain homeostasis leads homeostatic imbalance, OAJ Gerontol & Geriatric Med 3(2): OAJGGM.MS.ID.555607 (2018)
resulting in various disorders and disease states including Ǥ
Metabolic Alterations with Aging
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alterations over time at cellular, tissue and organ level in an Ǥ
DNA replication and cell division; the cells become senescent Ǥ ǡ
by alterations in the rate and accuracy of protein synthesis as 001
Open Access Journal of Gerontology & Geriatric Medicine
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ǡ insulin secretion and insulin sensitivity, and predisposes for
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Aging is an important risk factor for metabolic disorders including obesity, impaired glucose tolerance, and type 2 diabetes ȋʹȌǤ
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Ǧ ȏʹȐǤ one third of the elderly have diabetes and three quarters have Ǥ
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ȏ͵ȐǤʹ with aging are peripheral insulin resistance and impaired insulin
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ȏͶȐǤ impaired glucose tolerance through effects on insulin secretion
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Physiology of Insulin Secretion and Aging
Insulin is the major hormone for regulating glucose Ǥ
including muscle, liver, and adipose tissue and initiates signalling
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include regulation of glucose homeostasis through a decrease
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striated muscle and adipose tissue, and increase in lipid synthesis and attenuation of release of free fatty acid from triglycerides Ǥ
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process and involves the integration of various stimuli, such as nutrients mainly glucose and amino acid, hormones and ȏͷȐǤ
Aging and Glucose Metabolism Insulin Secretion and IR
Figure 1: Impact of Aging on Insulin Secretion.
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insulin pulse amplitudes, and decreased response to glucose
ȏȐǤ factors lead to decreased insulin secretion with age and include Ǧ
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mitochondrial function, as well as increased oxidative stress ȏǡͺȐǤ
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increased insulin demand because of increased insulin resistance with age results in impaired glucose homeostasis,
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with a decline of insulin action, which contributes to the high
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Ǥ animal studies, older rats showing approximately 50% reduction
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Aging and Calcium and Potassium Channels
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+ permeability, leads to cell membrane
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How to cite this article: Vinod Nikhra. The Altered Metabolic Homeostasis in Middle Aged and Elderly: Aging and Other Determinants of Insulin Secretion, Action and Resistance. OAJ Gerontol & Geriatric Med. 2018; 3(2): 555608.
Open Access Journal of Gerontology & Geriatric Medicine 2+ ϐǡ
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constitutes the major stimulus for exocytosis and regulates
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2+ is decreased with age, it is reasonable to speculate that insulin granule
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into adulthood to provide increased insulin secretion to match Ǥ ȾǦ
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superimposed on an increased demand for insulin, contributes to
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In fact, the age correlates with a decreased proliferative
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deposition of amylin in the islets of diabetic patients, which
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in the adults during periods of increased insulin demand such
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Visceral Fat, Aging and Insulin Action
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the lifespan in men and women of all ages and race, independent
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How to cite this article: Vinod Nikhra. The Altered Metabolic Homeostasis in Middle Aged and Elderly: Aging and Other Determinants of Insulin Secretion, Action and Resistance. OAJ Gerontol & Geriatric Med. 2018; 3(2): 555608.
Open Access Journal of Gerontology & Geriatric Medicine
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metabolic alterations, namely, increased rate of lipolysis in
exacerbates IR, and activation of hepatic gluconeogenesis in
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The Concept Central Insulin Resistance
central insulin action plays an important role in regulating
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signaling is an important determinant of the response to
ȏ͵ͶȐǤ Interestingly, evidence from recent research documents a link between diabetes and AD, a neurodegenerative disorder and
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ʹǦ͵ ǡ insulin levels and insulin activity in the central nervous system
ȏ͵ȐǤ human subjects showing that administration of insulin improves ȏ͵ȐǤ
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ǡ shown that the protein levels of elements in the insulin signalling
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in central and peripheral insulin resistance could contribute to Ǥ
Aging and Whole Body Glucose Homeostasis Impaired Glucose Tolerance
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Risk Factors for Glucose Homeostasis
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tolerance and lower level of insulin resistance than less active Ǥ
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in body composition due to decreased lean body mass and contractile strength with age contribute to the reduction in
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ȏͶͶȐǤ ǡ or treatment with activators of sirtuins, such as resveratrol protects against metabolic decline with aging, increases insulin sensitivity and insulin secretion, improves quality of life and Ǥ
References
1. ȋʹͲͳͲȌ ǡ ϐ
Ǥ
ͻͶǣ ͳǦͳ͵Ǥ 2. ǡ ȋʹͲͳͳȌ ʹ
Ǥ͵ȋȌǣͷͷǦͷͷǤ
3. ȋͳͻͺͺȌ
Ǥ ͵ȋͳʹȌǣͳͷͻͷǦͳͲǤ 4. ȋʹͲͲͲȌ
ʹ
Ǥ ͳͲȋͶȌǣͶͷͻǦͶͷǤ 5. ǡȋʹͲͳʹȌ
ǡʹǡ Ǥ
ͳǦͳ͵Ǥ 6. ǡ ȋʹͲͲ͵Ȍ
Ǥ
ƬʹͺͶȋͳȌǣǦͳʹǤ
How to cite this article: Vinod Nikhra. The Altered Metabolic Homeostasis in Middle Aged and Elderly: Aging and Other Determinants of Insulin Secretion, Action and Resistance. OAJ Gerontol & Geriatric Med. 2018; 3(2): 555608.
Open Access Journal of Gerontology & Geriatric Medicine 7. ǡ ǡǡ ȋʹͲͲͺȌǦ
ͳǦ
Ǧ
Ǧ
ϐ
ͳǦ ȋȌ
Ǥ ȋͳȌǣͺǦͺͺǤ 8. ǡ ǡ ȋʹͲͲͶȌ ǡ ȾǦ
apoptosis, and decreased insulin secretory capacity in mouse models
Ǥ
ͳͶͷȋͳͳȌǣͷ͵ͲͷǦͷ͵ͳʹǤ
9. ǡ ǡ ȋͳͻͻ͵Ȍ ʹ
ȾǦ
ǣ
Ǧ
ǤǡͶʹȋȌǣͳͲͷǦͳͲʹǤ 10. ǡ ǡ ȋʹͲͲͷȌ
control of glucose transporter 2 glycosylation promotes insulin
Ǥͳʹ͵ȋȌǣͳ͵ͲǦͳ͵ʹͳǤ
11. ǡ ǡ ȋʹͲͲȌ
Ǧ Ǥ
ȋ͵ȌǣͳͷͲǦͳͷͶǤ 12.
ǡ ǡ ȋʹͲͳͳȌ ʹ ȋʹʹȌ not the principal glucose transporter in human pancreatic beta cells: implications for understanding genetic association signals at this
Ǥ
ͳͲͶȋͶȌǣͶͺǦͷ͵Ǥ 13. ǡǡȋʹͲͲͷȌ
ʹ
ǤͶͺȋʹȌǣʹͺʹǦʹͺͻǤ
14. ǡ ǡ ǡ
ȋʹͲͲȌ
Ǧ ʹ
Ǧ
Ǥ
͵ͻȋͺȌǣͷǦͷͶǤ
15. ǡ ǡ ǡ ȋͳͻͺ͵Ȍ
Ǧ
Ǧ
Ǥ͵ʹȋͳͳȌǣͳͲͳͻǦͳͲʹͳǤ 16. ǡ ǡȋͳͻͺȌ
release and ion movements in isolated pancreatic islets of rats in old Ǥ ͵ͺͶǣ͵ͶǦ͵ͷͶǤ
17. ǡ
ǡ
ȋʹͲͲȌ
ȾǦ
ǣ
ǦͳǤͷͷȋͻȌǣʹͶͷͷǦʹͶʹǤ
18. ǡ ǡǦȋʹͲͲ͵ȌȾǦ
ϐ
ȾǦ
ʹǤͷʹȋͳȌǣͳͲʹǦ ͳͳͲǤ 19. ǡ ǡ ȋʹͲͲͳȌ
ȾǦ
Ǥ ͷͲȋͺȌǣͳͺ͵ǦͳͻͲǤ 20. ǡǡ ȋʹͲͲͻȌ
Ǥ
ͳͲȋʹȌǣͳͺͷǦͳͻͳǤ
21. ǡ ǡ ȋʹͲͳͲȌ
in alpha and beta cells in human and mouse islets and the role of
Ǧ͵Ǥͷ͵ȋȌǣͳͶͳͷǦͳͶʹǤ
22. ǡ
ǡ ȋʹͲͲͶȌ Ǧ
Ǥ ͷ͵ȋͺȌǣʹͲͺǦʹͲͻͶǤ 23. ǡ ǡ ǡ ȋʹͲͲ͵Ȍ
ǫǤͷʹȋȌǣͺͷͲǦͺͷǤ
005
24. ǡǡȋʹͲͲͷȌ
Ǥ ͳ͵ȋͳȌǣͳͳǦʹͲǤ 25. ǡȋʹͲͲͻȌ
Ǥ
ͳͻͲȋͳͲȌǣͳͳͳǦͳͳʹ͵Ǥ
26. ǡ ǡ ȋʹͲͲʹȌ
ǣ Ǧ
ǫǤͷͳȋͳͲȌǣʹͻͷͳǦʹͻͷͺǤ
27. ǡȋʹͲͲ͵Ȍ
ǣ
Ǥ ͺȋ͵Ȍǣ͵ͳǦ͵ͻǤ
28. ǡǡʹͲͲͺǤ
Ǥȋ͵ȌǣͶ͵ͺǦͶͶͲǤ
29. ǡ ȋʹͲͲͶȌ
Ǥ
ͺͻȋȌǣʹͷͶͺǦʹͷͷǤ
30. ǡ ǡȋʹͲͳͲȌ
ϐϐǤͳͺȋͷȌǣͺͻǦͺͺ͵Ǥ 31. ǡ ǡ ȋʹͲͳͲȌ Ǧ
ǣ
Ǥ
͵ͷȋͻ͵͵Ȍǣ ʹʹǦ ʹʹǤ
32.
ǡ
ǡ ȋʹͲͲͺȌ
Ǥ ͳͳͺȋȌǣ ʹͳ͵ʹǦʹͳͶǤ 33. ǡ
ǡȋʹͲͲȌ
Ǥ ͵ȋͳȌǣǦ͵Ǥ
34. ǡ
ȋʹͲͳͳȌ Ǧ
Ǧͳǣ
Ǥ ȋͷȌǣ͵ͷǦ͵Ǥ 35. ǡǡ ȋʹͲͲͷȌ Ǧ
ǯ Ǧ͵ǫǤ ǯȋͳȌǣ͵ǦͺͲǤ 36. ǡ ǡ ȋʹͲͳʹȌ
ǣ
Ǥ
ͻȋͳȌǣʹͻǦ͵ͺǤ 37.
ȋʹͲͲʹȌ
Ǥ ͷͳǣͶͳͷǦͶͷ͵Ǥ 38. ǡ ǡȋʹͲͲͳȌ
Ǧ
Ǥ
ͳȋ͵ȌǣʹʹǦʹ͵ͶǤ
39. ǡǡȋʹͲͲͳȌ
Ǥ ͳͷȋͳȌǣͳͲͺǦͳͳͶǤ
40. ǡ ǡ ȋʹͲͲͺȌ
Ǥ
ʹͻȋͳȌǣͶʹǦͳǤ 41. ǡ
ǡ
Ǧ ȋͳͻͻȌ
ǡ
ȋ ȌǤ ͶͷȋȌǣͻͶǦͻͷ͵Ǥ
42. ǡ ǡ ȋͳͻͻͷȌ
Ͷ
ǤͶͶȋͷȌǣͷͷͷǦͷͲǤ 43. ǡ
ȋʹͲͲͷȌ
ǦǦ ʹ
Ǥ ͳʹͲȋͶȌǣͶ͵ǦͶͺʹǤ
44. ǡ ȋʹͲͳͶȌ Ϊ Ǥ ʹͶȋͺȌǣͶͶǦͶͳǤ
How to cite this article: Vinod Nikhra. The Altered Metabolic Homeostasis in Middle Aged and Elderly: Aging and Other Determinants of Insulin Secretion, Action and Resistance. OAJ Gerontol & Geriatric Med. 2018; 3(2): 555608.