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慢性烟酰胺超载与2 型糖尿病流行的关系

周士胜, 李达, 周一鸣, 孙武平, 刘星星, 伦永志

大连大学医学院医学研究中心、辽宁省高校生物物理学重点实验室，大连 116622； 日本国立自然科学研究所冈崎综合生物科学研究所，冈崎 444-8787，日本

摘要

2 型糖尿病是全球性日益严重的公共卫生问题。目前人们普遍接受的观点是2 型糖尿病是基因与环境相互作用的结果，但二者如何作用尚不清楚。众所周知，饮食因素在糖尿病发病中起关键作用，而全球性糖尿病快速流行发生于尼亚新(烟酸或烟酰胺)强化食物之后，因此不能排除长期尼亚新摄入过量与糖尿病流行有关。我们最近的研究显示烟酰胺超载及解毒减慢均可引起氧化应激和胰岛素抵抗。本文结合相关文献资料，就尼亚新代谢、糖尿病人烟酰胺代谢特点、皮肤在烟酰胺代谢中的作用、药物对烟酰胺代谢的影响、以及饮食习惯和食品强化等因素与糖尿病流行的可能关系做一概述。我们认为，糖尿病时基因与环境相互作用的本质可能是长期烟酰胺超载所致的慢性中毒与机体相对较低的解毒/ 排泄能力的综合反映，因此，减少尼亚新摄入可能是遏制糖尿病流行的关键措施。

关键词： 尼亚新; 烟酰胺; 烟酸; 氧化应激; 胰岛素抵抗; 2 型糖尿病

分类号：R363.1+3; R363.2+1

[Chronic nicotinamide overload and type 2 diabetes.] [Ariticle in Chinese]

ZHOU Shi-Sheng, LI Da, ZHOU Yi-Ming, SUN Wu-Ping, LIU Xing-Xing, LUN Yong-Zhi

Key Laboratories of Biophysics of Liaoning Province, Institute of Basic Medical Sciences, Medical College, Dalian University,Dalian 116622, China； Okazaki Institute for Integrative Bioscience, National Institutes of Natural Sciences, Okazaki 444-8787,Japan

Abstract

Type 2 diabetes is a major global health problem. It is generally accepted that type 2 diabetes is the result of geneenvironmentalinteraction. However, the mechanism underlying the interaction is unclear. Diet change is known to play an importantrole in type 2 diabetes. The fact that the global high prevalence of type 2 diabetes has occurred following the spread of food fortificationworldwide suggests a possible involvement of excess niacin intake. Our recent study found that nicotinamide overload and lownicotinamide detoxification may induce oxidative stress associated with insulin resistance. Based on the relevant facts, this reviewbriefly summarized the relationship between the prevalence of type 2 diabetes and the nicotinamide metabolism changes induced byexcess niacin intake, aldehyde oxidase inhibitors, liver diseases and functional defects of skin. We speculate that the gene-environmentalinteraction in type 2 diabetes may be a reflection of the outcome of the association of chronic nicotinamide overload-induced toxicityand the relatively low detoxification/excretion capacity of the body. Reducing the content of niacin in foods may be a promising strategyfor the control of type 2 diabetes.

Key words: niacin; nicotinamide; nicotinic acid; oxidative stress; insulin resistance; type 2 diabetes mellitus

收稿日期：2009-11-13　　录用日期：2009-12-21

通讯作者：周士胜　　E-mail: zhouss@ymail.com

引用本文：

周士胜, 李达, 周一鸣, 孙武平, 刘星星, 伦永志. 慢性烟酰胺超载与2 型糖尿病流行的关系[J]. 生理学报 2010; 62 (1): 86-92.

ZHOU Shi-Sheng, LI Da, ZHOU Yi-Ming, SUN Wu-Ping, LIU Xing-Xing, LUN Yong-Zhi. [Chronic nicotinamide overload and type 2 diabetes.] [Ariticle in Chinese] . Acta Physiol Sin 2010; 62 (1): 86-92 (in Chinese with English abstract).