Pathogenesis of chronic hyperglycemia: from reductive stress to oxidative stress

J Diabetes Res. 2014:2014:137919. doi: 10.1155/2014/137919. Epub 2014 Jun 16.

Abstract

Chronic overnutrition creates chronic hyperglycemia that can gradually induce insulin resistance and insulin secretion impairment. These disorders, if not intervened, will eventually be followed by appearance of frank diabetes. The mechanisms of this chronic pathogenic process are complex but have been suggested to involve production of reactive oxygen species (ROS) and oxidative stress. In this review, I highlight evidence that reductive stress imposed by overflux of NADH through the mitochondrial electron transport chain is the source of oxidative stress, which is based on establishments that more NADH recycling by mitochondrial complex I leads to more electron leakage and thus more ROS production. The elevated levels of both NADH and ROS can inhibit and inactivate glyceraldehyde 3-phosphate dehydrogenase (GAPDH), respectively, resulting in blockage of the glycolytic pathway and accumulation of glycerol 3-phospate and its prior metabolites along the pathway. This accumulation then initiates all those alternative glucose metabolic pathways such as the polyol pathway and the advanced glycation pathways that otherwise are minor and insignificant under euglycemic conditions. Importantly, all these alternative pathways lead to ROS production, thus aggravating cellular oxidative stress. Therefore, reductive stress followed by oxidative stress comprises a major mechanism of hyperglycemia-induced metabolic syndrome.

Publication types

  • Research Support, N.I.H., Extramural
  • Review

MeSH terms

  • Diabetes Mellitus, Type 2 / physiopathology
  • Electron Transport
  • Glucose / metabolism
  • Glycation End Products, Advanced / metabolism
  • Glyceraldehyde-3-Phosphate Dehydrogenases / metabolism
  • Glycerophosphates / metabolism
  • Humans
  • Hyperglycemia / physiopathology*
  • Metabolic Syndrome / physiopathology
  • Mitochondria / metabolism
  • NAD / metabolism
  • Oxidative Stress*
  • Protein Kinase C / metabolism
  • Reactive Oxygen Species / metabolism*
  • Superoxides / metabolism

Substances

  • Glycation End Products, Advanced
  • Glycerophosphates
  • Reactive Oxygen Species
  • NAD
  • Superoxides
  • alpha-glycerophosphoric acid
  • Glyceraldehyde-3-Phosphate Dehydrogenases
  • Protein Kinase C
  • Glucose