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Fig. 2 | Journal of Biomedical Science

Fig. 2

From: Role of mitochondrial dysfunction and dysregulation of Ca2+ homeostasis in the pathophysiology of insulin resistance and type 2 diabetes

Fig. 2

Illustration of the role of defects in mitochondria-mediated regulation of Ca2+ homeostasis in the pathogenesis of insulin resistance and type 2 diabetes. The intracellular level of Ca2+ ions in a normal human cell is regulated and maintained within a small range of concentration. The fluctuation of the level of Ca2+ ions from extracellular influx or release of intra-organelle leads to activation of Ca2+-dependent signaling to alter the gene expression or protein trafficking in response to the stimulation (i.e., adiponectin or norepinephrine). Increase of cytosolic level of Ca2+ ions initiates the activation of insulin signaling and transcriptional regulation in insulin-responsive tissues such as adipocytes and muscle. On the other hand, Ca2+ ions can facilitate insulin secretion in beta cells. All of these effects are beneficial to glucose utilization and insulin sensitivity in the human body. For instance, the Ca2+-dependent activation of FAM3A improves phosphorylation of AKT and the activation of CaMKII or synaptotagmin VII (Syt VII) allow efficient translocation/docking/fusion of glucose transporter 4 (Glut4) to the plasma membrane in insulin- responsive cells upon insulin stimulation. Moreover, Ca2+ homeostasis also regulates gene transcription to affect adipogenesis, muscle trophism, and mitochondrial biogenesis through Ca2+-dependent activation of a number of proteins. Mitochondria modulate intracellular Ca2+ homeostasis by its high capacity of Ca2+ uptake through the MCU complex and interaction with ER via the MAMs structure. Mitochondrial Ca2+ uptake plays as a role in the buffering of cytosolic Ca2+ ions and in the boost of the ATP production. Three enzymes (PDH, IDH, ╬▒KGDH) involved in oxidative metabolism are regulated by Ca2+ ions directly or indirectly, providing more NADH to the electron transport chain (ETC). Mitochondrial dysfunction disrupts intracellular Ca2+ homeostasis and leads to dysregulation of the above-mentioned Ca2+-dependent signaling events and impairment of glucose utilization and insulin response in the affected cells. Ultimately, these abnormalities will culminate in insulin insensitivity of target tissue cells and thereby develop T2D

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