25、ral etiology of DM in humans is circumstantial though in animal studies the evidence is good. Viruses implicated include rubella (congenital), mumps, cytomegalovirus and Coxsackie B. Dietary agents. Controversially, those implicated include cows milk (containing bovine serum albumin), preserved meat 。

26、s (containing nitrosamines) and coffee. etiology of type 1 DM Immune markers（免疫标记）（免疫标记） Type 1 DM is characterized by the presence of T lymphocytes within the pancreatic islets that may play a key role in islet destruction. Patients with type 1 DM have circulating antibodies against the islets. Ant 。

27、ibodies against the insulin molecule, the enzyme gamma-amino butyric acid decarboxylase (GAD) or the tyrosine kinase IA-2 have been well characterized. etiology of type 1 DM Genetic associations（遗传关联）（遗传关联） Studies in twins indicate that approximately 30-90% of the risk of type 2 diabetes is genetic 。

28、. Prevalence of type 2 DM is very high in certain ethnic groups including Pima Indians in Arizona, Naruans in Polynesia, and Indian sub-continent Asians in the UK. The etiology of type 2 diabetes mellitus Environmental factors（环境因素）（环境因素） Obesity (especially central), aging, physical inactivity. The 。

29、se increase insulin resistance. Poor fetal development（胎儿发育不良）. This (the thrifty phenotype hypothesis) is thought to lead to metabolic sequelae predisposing to type 2 diabetes Hypertension, lipoprotein abnormalities and coronary disease in later life. The etiology of type 2 diabetes mellitus Diabet 。

30、ic retinopathy Leading cause of blindness in working-age adults Diabetic nephropathy Leading cause of end-stage renal disease Cardiovascular disease Stroke 1.2- to 1.8-fold increase in stroke Diabetic neuropathy Leading cause of non-traumatic lower extremity amputations 75% diabetic patients die fro 。

31、m CV events (并发症）并发症） . Complications of DM 动脉粥样硬化动脉粥样硬化 0.6 0.8 1.0 1.2 1.4 1.6 1.8 Odds ratio for incident CVD AgeSmoking Total cholesterol: HDL cholesterol Insulin resistance Complications of DM Macrosomic baby Complications of DM 跨膜信号转导的一般步骤跨膜信号转导的一般步骤 特定的细胞释放信息物质特定的细胞释放信息物质 信息物质经扩散或血循环到达靶细胞信息物质 。

32、经扩散或血循环到达靶细胞 与靶细胞的受体特异性结合与靶细胞的受体特异性结合 受体对信号进行转换并启动细胞内信使系统受体对信号进行转换并启动细胞内信使系统 靶细胞产生生物学效应靶细胞产生生物学效应 （一）神经递质（一）神经递质 又称突触分泌信号又称突触分泌信号(synaptic signal) 根据细胞分泌信息物质的方式 ， 将细胞间信息物质根据细胞分泌信息物质的方式 ， 将细胞间信息物质 分为四类：分为四类： （二）（二） 内分泌激素内分泌激素 又称内分泌信号又称内分泌信号(endocrine signal) （三）局部化学介质（三）局部化学介质 又称又称旁分泌信号旁分泌信号(paracrine si 。

33、gnal （四）气体信号（四）气体信号 (Gas signal) 1921年 ， 用胰腺提取物成功降低切除胰腺的狗的 血糖 。
In July 1921, a dog that had had its pancreas surgically removed was injected with an extract collected from a duct-tied dog. In the two hours that followed the injection, the blood sugar level of the dog fell, and its condition improved.。

34、Changes in blood levels of glucose, insulin, and glucagon after a carbohyrate- rich meal (ingested at time 0 minutes). Insulinase found in the liver and kidneys breaks down insulin circulating in the plasma Insulin has a half-life of only about 6 minutes. 胰岛素在肝脏和肾脏降解 。
肝脏和肾脏的胰岛素酶分胰岛素在肝脏和肾脏降解 。
肝脏和肾脏的胰岛素 。

35、酶分 解血浆中的胰岛素解血浆中的胰岛素 胰岛素的半衰期约胰岛素的半衰期约6分钟分钟 Environmental factors（环境因素）（环境因素） Obesity (especially central), aging, physical inactivity. These increase insulin resistance. Poor fetal development（胎儿发育不良）. This (the thrifty phenotype hypothesis) is thought to lead to metabolic sequelae predisposing to ty 。

36、pe 2 diabetes Hypertension, lipoprotein abnormalities and coronary disease in later life. The etiology of type 2 diabetes mellitus Diabetic retinopathy Leading cause of blindness in working-age adults Diabetic nephropathy Leading cause of end-stage renal disease Cardiovascular disease Stroke 1.2- to 1.8-fold increase in stroke Diabetic neuropathy Leading cause of non-traumatic lower extremity amputations 75% diabetic patients die from CV events (并发症）并发症） . 。

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标题：内分泌|内分泌的分子生物学final( 三 )