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1.
Methods Mol Biol ; 1732: 343-361, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29480486

RESUMO

Here we describe an assay for simultaneous measurement of cellular uptake rates of long-chain fatty acids (LCFA) and glucose that can be applied to cells in suspension. The uptake assay includes the use of radiolabeled substrates at such concentrations and incubation periods that exact information is provided about unidirectional uptakes rates. Cellular uptake of both substrates is under regulation of AMPK. The underlying mechanism includes the translocation of LCFA and glucose transporters from intracellular membrane compartments to the cell surface, leading to an increase in substrate uptake. In this chapter, we explain the principles of the uptake assay before detailing the exact procedure. We also provide information of the specific LCFA and glucose transporters subject to AMPK-mediated subcellular translocation. Finally, we discuss the application of AMPK inhibitors and activators in combination with cellular substrate uptake assays.


Assuntos
Proteínas Quinases Ativadas por AMP/metabolismo , Ensaios Enzimáticos/métodos , Ácidos Graxos/metabolismo , Glucose/metabolismo , Animais , Células Cultivadas , Ensaios Enzimáticos/instrumentação , Transportador de Glucose Tipo 4/metabolismo , Membranas Intracelulares/metabolismo , Miócitos Cardíacos/citologia , Miócitos Cardíacos/metabolismo , Cultura Primária de Células , Ratos
2.
Mol Cell Endocrinol ; 460: 134-151, 2018 01 15.
Artigo em Inglês | MEDLINE | ID: mdl-28736255

RESUMO

Augmenting glucose utilization and energy expenditure in skeletal muscle via AMP-activated protein kinase (AMPK) is an imperative mechanism for the management of type 2 diabetes. Chemical derivatives (2a-2h, 3, 4a-4d, 5) of the isoalantolactone (K007), a bioactive molecule from roots of Inula racemosa were synthesized to optimize the bioactivity profile to stimulate glucose utilization in skeletal muscle cells. Interestingly, 4a augmented glucose uptake, driven by enhanced translocation of glucose transporter 4 (GLUT4) to cell periphery in L6 rat skeletal muscle cells. The effect of 4a was independent to phosphatidylinositide-3-kinase (PI-3-K)/Akt pathway, but mediated through Liver kinase B1 (LKB1)/AMPK-dependent signaling, leading to activation of downstream targets acetyl coenzyme A carboxylase (ACC) and sterol regulatory element binding protein 1c (SREBP-1c). In db/db mice, 4a administration decreased blood glucose level and improved body mass index, lipid parameters and glucose tolerance associated with elevation of GLUT4 expression in skeletal muscle. Moreover, 4a increased energy expenditure via activating substrate utilization and upregulated the expression of thermogenic transcription factors and mitochondrial proteins in skeletal muscle, suggesting the regulation of energy balance. These findings suggest the potential implication of isoalantolactone derivatives for the management of diabetes.


Assuntos
Proteínas Quinases Ativadas por AMP/metabolismo , Diabetes Mellitus Experimental/metabolismo , Metabolismo Energético/efeitos dos fármacos , Glucose/metabolismo , Músculo Esquelético/metabolismo , Sesquiterpenos/farmacologia , Transdução de Sinais , Animais , Membrana Celular/efeitos dos fármacos , Membrana Celular/metabolismo , Diabetes Mellitus Experimental/patologia , Regulação da Expressão Gênica/efeitos dos fármacos , Transportador de Glucose Tipo 4/metabolismo , Metabolismo dos Lipídeos/efeitos dos fármacos , Metabolismo dos Lipídeos/genética , Masculino , Camundongos Endogâmicos C57BL , Fibras Musculares Esqueléticas/efeitos dos fármacos , Fibras Musculares Esqueléticas/metabolismo , Músculo Esquelético/efeitos dos fármacos , Fosfatidilinositol 3-Quinases/metabolismo , Transporte Proteico , Ratos , Sesquiterpenos/química , Fatores de Tempo
3.
Cell Rep ; 18(4): 1005-1018, 2017 01 24.
Artigo em Inglês | MEDLINE | ID: mdl-28122227

RESUMO

The RPL11-MDM2 interaction constitutes a p53 signaling pathway activated by deregulated ribosomal biosynthesis in response to stress. Mice bearing an MDM2C305F mutation that disrupts RPL11-MDM2 binding were analyzed on a high-fat diet (HFD). The Mdm2C305F/C305F mice, although phenotypically indistinguishable from wild-type (WT) mice when fed normal chow, demonstrated decreased fat accumulation along with improved insulin sensitivity and glucose tolerance after prolonged HFD feeding. We found that HFD increases expression of c-MYC and RPL11 in both WT and Mdm2C305F/C305F mice; however, p53 was induced in WT but not in Mdm2C305F/C305F mice. Reduced p53 activity in HFD-fed Mdm2C305F/C305F mice resulted in higher levels of p53 downregulated targets GLUT4 and SIRT1, leading to increased biosynthesis of NAD+, and increased energy expenditure. Our study reveals a role for the RPL11-MDM2-p53 pathway in fat storage during nutrient excess and suggests that targeting this pathway may be a potential treatment for obesity.


Assuntos
Dieta Hiperlipídica , Obesidade/etiologia , Proteínas Proto-Oncogênicas c-mdm2/metabolismo , Proteína Supressora de Tumor p53/metabolismo , Tecido Adiposo/metabolismo , Animais , Diferenciação Celular , Linhagem Celular , Metabolismo Energético , Regulação da Expressão Gênica , Transportador de Glucose Tipo 4/genética , Transportador de Glucose Tipo 4/metabolismo , Longevidade , Camundongos , NAD/biossíntese , Nicotinamida N-Metiltransferase/genética , Nicotinamida N-Metiltransferase/metabolismo , Obesidade/metabolismo , Obesidade/mortalidade , Polimorfismo de Nucleotídeo Único , Proteínas Proto-Oncogênicas c-mdm2/genética , Proteínas Proto-Oncogênicas c-myc/metabolismo , Proteínas Ribossômicas/metabolismo , Sirtuína 1/genética , Sirtuína 1/metabolismo , Taxa de Sobrevida
4.
Animal ; 9(1): 104-9, 2015 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-25245143

RESUMO

Exercise has been shown to increase mRNA expression of a growing number of genes. The aim of this study was to assess if mRNA expression of the metabolism- and oxidative stress-related genes GLUT4 (glucose transporter 4), COX2 (cyclooxygenase 2), SOD1 (superoxide dismutase 1) and HSP70 (heat shock protein 70) in saliva changes following acute exercise stress in dogs. For this purpose, 12 avalanche dogs of the Italian Military Force Guardia di Finanza were monitored during simulation of a search for a buried person in an artificial avalanche area. Rectal temperature (RT) and saliva samples were collected the day before the trial (T0), immediately after the descent from a helicopter at the onset of a simulated avalanche search and rescue operation (T1), after the discovery of the buried person (T2) and 2 h later (T3). Expressions of GLUT4, SOD1, COX2 and HSP70 were measured by real-time PCR. The simulated avalanche search and rescue operation was shown to exert a significant effect on RT, as well as on the expression of all metabolism- and oxidative stress-related genes investigated, which peaked at T2. The observed expression patterns indicate an acute exercise stress-induced upregulation, as confirmed by the reductions in expression at T3. Moreover, our findings indicate that saliva is useful for assessing metabolism- and oxidative stress-related genes without the need for restraint, which could affect working dog performance.


Assuntos
Cães/fisiologia , Metabolismo Energético/fisiologia , Estresse Oxidativo/genética , Condicionamento Físico Animal/fisiologia , Saliva/metabolismo , Animais , Avalanche , Biomarcadores/análise , Ciclo-Oxigenase 2/genética , Ciclo-Oxigenase 2/metabolismo , Metabolismo Energético/genética , Transportador de Glucose Tipo 4/genética , Transportador de Glucose Tipo 4/metabolismo , Proteínas de Choque Térmico HSP70/genética , Proteínas de Choque Térmico HSP70/metabolismo , Masculino , Militares , RNA Mensageiro/metabolismo , Distribuição Aleatória , Reação em Cadeia da Polimerase em Tempo Real/veterinária , Superóxido Dismutase/genética , Superóxido Dismutase/metabolismo , Superóxido Dismutase-1 , Regulação para Cima
5.
Islets ; 6(2): e29221, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-25483959

RESUMO

Regular exercise has been shown to improve many complications of Type 1 diabetes mellitus (T1DM) including enhanced glucose tolerance and increased cardiac function. While exercise training has been shown to increase insulin content in pancreatic islets of rats with T1DM, experimental models were severely hyperglycemic and not undergoing insulin treatment. Further, research to date has yet to determine how exercise training alters glucagon content in pancreatic islets. The purpose of the present investigation was to determine the impact of a 10-week aerobic training program on pancreatic islet composition in insulin-treated rats with T1DM. Second, it was determined whether the acute, exercise-mediated reduction in blood glucose experienced in rats with T1DM would become larger in magnitude following aerobic exercise training. Diabetes was induced in male Sprague-Dawley rats by multiple low dose injections of streptozotocin (20mg/kg i.p.) and moderate intensity aerobic exercise training was performed on a motorized treadmill for one hour per day for a total of 10 weeks. Rats with T1DM demonstrated significantly less islet insulin, and significantly more islet glucagon hormone content compared with non-T1DM rats, which did not significantly change following aerobic training. The reduction in blood glucose in response to a single exercise bout was similar across 10 weeks of training. Results also support the view that different subpopulations of islets exist, as small islets (<50 µm diameter) had significantly more insulin and glucagon in rats with and without T1DM.


Assuntos
Glicemia/metabolismo , Diabetes Mellitus Experimental/sangue , Diabetes Mellitus Tipo 1/sangue , Glucagon/metabolismo , Insulina/metabolismo , Ilhotas Pancreáticas/metabolismo , Condicionamento Físico Animal/fisiologia , Animais , Diabetes Mellitus Experimental/tratamento farmacológico , Diabetes Mellitus Tipo 1/tratamento farmacológico , Transportador de Glucose Tipo 4/metabolismo , Insulina/uso terapêutico , Ilhotas Pancreáticas/patologia , Masculino , Ratos , Ratos Sprague-Dawley , Receptor de Insulina/metabolismo
6.
Int J Sport Nutr Exerc Metab ; 24(1): 2-13, 2014 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-23918588

RESUMO

OBJECTIVES: The primary aims of the study were to examine the effect of resveratrol on skeletal muscle SIRT1 expression and energy expenditure in subjects with Type 2 diabetes mellitus (T2DM). BACKGROUND: Animal and in vivo studies indicate that resveratrol increases SIRT1 expression that stimulates PGC1α activity. Subsequent upregulation of AMPK and GLUT4 expression are associated with improved insulin sensitivity in peripheral tissues. METHODS: Ten subjects with T2DM were randomized in a double-blind fashion to receive 3g resveratrol or placebo daily for 12 weeks. Secondary outcomes include measures of AMPK, p-AMPK and GLUT4 expression levels, energy expenditure, physical activity levels, distribution of abdominal adipose tissue and skeletal muscle fiber type composition, body weight, HbA1c, plasma lipid subfraction, adiponectin levels, and insulin sensitivity. RESULTS: There was a significant increase in both SIRT1 expression (2.01 vs. 0.86 arbitrary units [AU], p = .016) and p-AMPK to AMPK expression ratio (2.04 vs. 0.79 AU, p = .032) in the resveratrol group compared with the placebo group. Although the percentage of absolute change (8.6 vs. -13.9%, p = .033) and percentage of predicted resting metabolic rate (RMR; 7.8 vs. -13.9%, p = .013) were increased following resveratrol, there was a significant reduction in average daily activity (-38 vs. 43.2%, p = .028) and step counts (-39.5 vs. 11.8%, p = .047) when compared with placebo. CONCLUSIONS: In patients with T2DM, treatment with resveratrol regulates energy expenditure through increased skeletal muscle SIRT1 and AMPK expression. These findings indicate that resveratrol may have beneficial exercise-mimetic effects in patients with T2DM.


Assuntos
Diabetes Mellitus Tipo 2/metabolismo , Metabolismo Energético/efeitos dos fármacos , Resistência à Insulina , Músculo Esquelético/metabolismo , Esforço Físico/efeitos dos fármacos , Sirtuína 1/metabolismo , Estilbenos/farmacologia , Proteínas Quinases Ativadas por AMP/metabolismo , Metabolismo Basal/efeitos dos fármacos , Método Duplo-Cego , Exercício Físico , Transportador de Glucose Tipo 4/metabolismo , Humanos , Masculino , Pessoa de Meia-Idade , Coativador 1-alfa do Receptor gama Ativado por Proliferador de Peroxissomo , Extratos Vegetais/farmacologia , Descanso , Resveratrol , Fatores de Transcrição/metabolismo , Vitis/química
7.
Cell Biochem Biophys ; 67(3): 1261-74, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-23700164

RESUMO

The type 2 diabetes is increasing rapidly around the globe. The primary cause for this is insulin resistance due to the disruption of the insulin signal transduction mechanism. Insulin signal transduction stimulates glucose transport through the glucose transporter GLUT4, by promoting the exocytosis process. Understanding the structural topology of GLUT4 mechanism will increase our understanding of the dynamic activities about glucose transport and its regulation in the membrane environment. However, little is known about the topology of GLUT4. In this article, we have determined the amino acid composition, disulfide topology, structure conformation pattern of GLUT4. The amino acid composition portrays that leucine composition is the highest contributing to 15.5% among all other amino acids. Three cysteine residues such as Cys223, Cys361, and Cys363 were observed and the last two were associated with one disulfide bond formation. We have generated surface cavities to know the clefts/pockets on the surface of this protein that showed few irregular cavities placed mostly in the transmembrane-helical part. Besides, topology mapping of 12 transmembrane-helixes was done to predict N- and O-glycosylation sites and to show the highly glycosylated GLUT4 that includes both N- and O-glycosylation sites. Furthermore, hydrophobic segment and molecular charge distribution were analyzed. This article shows that bioinformatics tools can provide a rapid methodology to predict the topology of GLUT4. It also provides insights into the structural details and structural functioning relationships in the human GLUT4. The results can be of great help to advance future drug development research using GLUT4 as a target protein.


Assuntos
Biologia Computacional , Transportador de Glucose Tipo 4/química , Insulina/metabolismo , Sequência de Aminoácidos , Transporte Biológico , Bases de Dados de Proteínas , Glucose/metabolismo , Transportador de Glucose Tipo 4/metabolismo , Glicosilação , Humanos , Interações Hidrofóbicas e Hidrofílicas , Cadeias de Markov , Dados de Sequência Molecular , Estrutura Secundária de Proteína , Estrutura Terciária de Proteína
8.
J Clin Endocrinol Metab ; 98(2): E321-7, 2013 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-23341487

RESUMO

CONTEXT: Obesity is characterized by decreased insulin-stimulated glucose uptake in muscle and shift from glucose to lipid oxidation, the so-called metabolic inflexibility. Biliopancreatic diversion (BPD), a mainly malabsorptive bariatric operation, determines a prompt improvement of insulin resistance, but the mechanisms are still unclear. OBJECTIVE: We aimed to estimate the response of glucose transporter 4 (GLUT4) and hexokinase-II (HKII) gene expression to hyperinsulinemia before and after surgical treatment with a BPD or dietary-induced weight loss. The association with 24-hour energy expenditure and its different components-diet-induced thermogenesis (DIT), resting energy expenditure, physical activity (PA) of daily living, and physical exercise-was also determined. DESIGN, SETTING, AND MAIN OUTCOME MEASURES: Case-control study: 20 subjects, BPD vs diet-induced weight loss. Four subjects withdrew in the surgical arm and 1 subject withdrew in the dietary arm. Insulin sensitivity was measured by the euglycemic-hyperinsulinemic clamp. Energy expenditure was assessed by indirect calorimetry over 24 hours. Muscle biopsies were obtained during the clamp to measure gene expression: GLUT4 and HKII. RESULTS: Insulin sensitivity increased significantly (P < .01) only after BPD (0.101 ± 0.012 to 0.204 ± 0.033 µmol/kg/min/pM). Enhanced GLUT4 and HKII mRNA levels were observed after surgery (P < .0001 and P = .021, respectively), whereas they were not affected by diet-induced weight loss. Carbohydrate oxidation (P = .0027), DIT (P = .033), PA (P = .036), and energy expenditure during the exercise (P = .017) increased only in the BPD group. CONCLUSIONS: BPD improved impaired glucose metabolism and insulin resistance through increased glucose uptake, glycogen synthesis, and glucose oxidation. Furthermore, the concomitant increase in DIT, PA, and exercise in BPD patients may partly explain their ability to sustained long-term weight loss and may contribute to the improved insulin sensitivity.


Assuntos
Cirurgia Bariátrica , Metabolismo Energético/fisiologia , Transportador de Glucose Tipo 4/genética , Hexoquinase/genética , Músculo Esquelético/metabolismo , Obesidade/cirurgia , Adulto , Estudos de Casos e Controles , Feminino , Expressão Gênica , Glucose/metabolismo , Técnica Clamp de Glucose , Transportador de Glucose Tipo 4/metabolismo , Hexoquinase/metabolismo , Humanos , Insulina/metabolismo , Resistência à Insulina/fisiologia , Masculino , Pessoa de Meia-Idade , Obesidade/genética , Obesidade/metabolismo , Resultado do Tratamento
9.
Diabetes ; 60(1): 30-8, 2011 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-20876717

RESUMO

OBJECTIVE: Previous studies have demonstrated that the VAMP8 protein plays a complex role in the control of granule secretion, transport vesicle trafficking, phagocytosis, and endocytosis. The present study was aimed to investigate the role of VAMP8 in mediating GLUT4 trafficking and therefore insulin action in mice. RESEARCH DESIGN AND METHODS: Physiological parameters were measured using Oxymax indirect calorimetry system in 12-week-old VAMP8 null mice. Dynamic analysis of glucose homeostasis was assessed using euglycemic-hyperinsulinemic clamp coupled with tracer radioactively labeled 2-deoxyglucose. Insulin stimulated GLUT4 protein expressions on muscle cell surface were examined by immunofluorescence microscopy. RESULTS: VAMP8 null mice display reduced adiposity with increased energy expenditure despite normal food intake and reduced spontaneous locomotor activity. In parallel, the VAMP8 null mice also had fasting hypoglycemia (84 ± 11 vs. 115 ± 4) and enhanced glucose tolerance with increased insulin sensitivity due to increases in both basal and insulin-stimulated glucose uptake in skeletal muscle (0.19 ± 0.04 vs. 0.09 ± 0.01 mmol/kg/min during basal, 0.6 ± 0.04 vs. 0.31 ± 0.06 mmol/kg/min during clamp in red-gastrocnemius muscle, P < 0.05). Consistent with a role for VAMP8 in the endocytosis of the insulin-responsive GLUT4, sarcolemma GLUT4 protein levels were increased in both the basal and insulin-stimulated states without any significant change in the total amount of GLUT4 protein or related facilitative glucose transporters present in skeletal muscle, GLUT1, GLUT3, and GLUT11. CONCLUSIONS: These data demonstrate that, in the absence of VAMP8, the relative subcellular distribution of GLUT4 is altered, resulting in increased sarcolemma levels that can account for increased glucose clearance and insulin sensitivity.


Assuntos
Transportador de Glucose Tipo 4/metabolismo , Glucose/metabolismo , Insulina/fisiologia , Proteínas R-SNARE/fisiologia , Tecido Adiposo/anatomia & histologia , Animais , Peso Corporal , Calorimetria Indireta , Metabolismo Energético , Técnica Clamp de Glucose , Teste de Tolerância a Glucose , Humanos , Hiperinsulinismo , Insulina/farmacologia , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Camundongos Knockout , Fagocitose , Policitemia , Proteínas R-SNARE/deficiência , Redução de Peso/genética
10.
Proc Natl Acad Sci U S A ; 108(1): 403-8, 2011 Jan 04.
Artigo em Inglês | MEDLINE | ID: mdl-21173252

RESUMO

Brown adipocytes are multilocular lipid storage cells that play a crucial role in nonshivering thermogenesis. Uncoupling protein 1 (UCP1) is a unique feature of brown fat cells that allows heat generation on sympathetic nervous system stimulation. As conventional transcriptional factors that are activated in various signaling pathways, liver-X receptors (LXRs) play important roles in many physiological processes. The role of LXRs in the regulation of energy homeostasis remains unclear, however. Female WT, LXRαß(-/-), LXRα(-/-), and LXRß(-/-) mice were fed with either a normal diet (ND) or a high-carbohydrate diet (HCD) supplemented with or without GW3965-LXR agonist. LXRαß(-/-) mice exhibited higher energy expenditure (EE) as well as higher UCP1 expression in brown adipose tissue (BAT) compared with WT mice on the HCD. In addition, long-term treatment of WT mice with GW3965 showed lower EE at thermoneutrality (30 °C) and lower Ucp1 expression level in BAT. Furthermore, H&E staining of the BAT of LXRαß(-/-) mice exhibited decreased lipid droplet size compared with WT mice on the HCD associated with a more intense UCP1-positive reaction. Quantification of triglyceride (TG) content in BAT showed lower TG accumulation in LXRß(-/-) mice compared with WT mice. Surprisingly, GW3965 treatment increased TG content (twofold) in the BAT of WT and LXRα(-/-) mice but not in LXRß(-/-) mice. Furthermore, glucose transporter (GLUT4) in the BAT of LXRα(-/-) and LXRß(-/-) mice was sixfold and fourfold increased, respectively, compared with WT mice on the ND. These findings suggest that LXRα as well as LXRß could play a crucial role in the regulation of energy homeostasis in female mice and may be a potential target for the treatment of obesity and energy regulation.


Assuntos
Tecido Adiposo Marrom/metabolismo , Metabolismo Energético/fisiologia , Canais Iônicos/metabolismo , Proteínas Mitocondriais/metabolismo , Receptores Nucleares Órfãos/metabolismo , Termogênese/fisiologia , Tecido Adiposo Marrom/fisiologia , Análise de Variância , Animais , Benzoatos/farmacologia , Benzilaminas/farmacologia , Glicemia , Western Blotting , Calorimetria , Feminino , Transportador de Glucose Tipo 4/metabolismo , Imuno-Histoquímica , Receptores X do Fígado , Imageamento por Ressonância Magnética , Camundongos , Camundongos Endogâmicos C57BL , Camundongos Knockout , Receptores Nucleares Órfãos/agonistas , Receptores Nucleares Órfãos/genética , Receptores Nucleares Órfãos/fisiologia , Reação em Cadeia da Polimerase , Isoformas de Proteínas/agonistas , Isoformas de Proteínas/genética , Isoformas de Proteínas/metabolismo , Isoformas de Proteínas/fisiologia , Triglicerídeos/metabolismo , Proteína Desacopladora 1
11.
Endokrynol Pol ; 61(3): 269-74, 2010.
Artigo em Inglês | MEDLINE | ID: mdl-20602301

RESUMO

INTRODUCTION: GLUT4 is a representative of the family of integral membrane proteins which facilitate glucose transport across cellular membranes. In the available literature there is no publication referring to the investigations of glucotransporter expression in pre-diabetic subjects. However, GLUT4 protein overexpression was shown in leukocytes of diabetic patients. The aim of this study was to compare GLUT4 quantitative expression in peripheral blood lymphocytes in type 2 diabetes mellitus risk groups to healthy subjects. MATERIAL AND METHODS: The study groups included 15 pre-diabetic subjects and 15 persons with normal glucose tolerance and positive family history of type 2 diabetes mellitus (first-degree relatives). As a control group, 15 healthy persons with no family history of diabetes were enrolled. The expression of GLUT4 on the surface of peripheral blood lymphocytes was investigated with the use of indirect immunofluorescence. Quantitative determination of GLUT4 was performed with the use of flow cytometry. RESULTS: In the control group, GLUT4 expression amounted to 12 + or - 1.5% and was significantly lower in relation to both pre-diabetic subjects (18.2 + or - 8.8%; p = 0.008) and the positive family history group (17.9 + or - 9%; p = 0.001). CONCLUSIONS: GLUT4 overexpression in subjects with positive family history of type 2 diabetes mellitus suggests that cellular glucose transport disturbances occur prior to hyperglycaemia. Determination of GLUT4 expression appears to be a possibly useful method of early detection in individuals at high risk of diabetes.


Assuntos
Diabetes Mellitus Tipo 2/diagnóstico , Diabetes Mellitus Tipo 2/metabolismo , Transportador de Glucose Tipo 4/metabolismo , Leucócitos/metabolismo , Estado Pré-Diabético/metabolismo , Adulto , Idoso , Transporte Biológico , Biomarcadores/metabolismo , Diagnóstico Precoce , Feminino , Glucose/metabolismo , Humanos , Masculino , Pessoa de Meia-Idade
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