胰岛素抵抗(IR)是与2型糖尿病(T2DM)、高血压、血脂紊乱等疾病有关的一种复杂的代谢紊乱性疾病,这些与IR相关的疾病均是心血管疾病的独立性危险因素.脂代谢紊乱对细胞具有脂毒性作用,会引起或加重IR,其典型表现是血浆甘油三酯(TG)和游离脂肪酸(FFA)水平升高,其中血浆FFA升高是IR的独立致病因素.虽然FFA导致IR的具体机制还不完全清楚,但已证实FFA可通过内质网应激、氧化应激作用、凋亡和炎症作用等引发IR.本文概述了参与这些致病过程的相关分子及其作用机制,为FFA导致IR的致病机制研究提供理论依据,同时为临床治疗IR和预防T2DM提供参考.%Insulin resistance (IR) is a complex metabolic disorder related to several diseases including type 2 diabetes (T2DM), hypertension and dyslipidemia. These diseases are all independent risk factors for cardiovascular disease. Lipid metabolism disorder has toxic effects on cells and may cause or aggravate IR in performance of elevated plasma levels of triglyceride (TG) and free fatty acids (FFA), the last one is an independent risk factor for IR. It has been clear that FFA may induce IR by endoplasmic reticulum (ER) stress, oxidative stress, apoptosis and inflammation, although the specific mechanisms remained unknown. The present paper summarizes the related molecules involved in the pathogenic process of IR and its mechanism, might provide a theoretical basis for the molecular mechanism of IR caused by FFA, and therapeutic reference for clinical treatment of IR and prevention of T2DM.
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