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      The Critical Role of Metabolic Pathways in Aging

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          Abstract

          Aging is characterized by a deterioration in the maintenance of homeostatic processes over time, leading to functional decline and increased risk for disease and death. The aging process is characterized metabolically by insulin resistance, changes in body composition, and physiological declines in growth hormone (GH), insulin-like growth factor-1 (IGF-1), and sex steroids. Some interventions designed to address features of aging, such as caloric restriction or visceral fat depletion, have succeeded in improving insulin action and life span in rodents. Meanwhile, pharmacologic interventions and hormonal perturbations have increased the life span of several mammalian species without necessarily addressing features of age-related metabolic decline. These interventions include inhibition of the mammalian target of rapamycin and lifetime deficiency in GH/IGF-1 signaling. However, strategies to treat aging in humans, such as hormone replacement, have mostly failed to achieve their desired response. We will briefly discuss recent advances in our understanding of the complex role of metabolic pathways in the aging process and highlight important paradoxes that have emerged from these discoveries. Although life span has been the major outcome of interest in the laboratory, a special focus is made in this study on healthspan, as improved quality of life is the goal when translated to humans.

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          Most cited references39

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          Mammalian sirtuins: biological insights and disease relevance.

          Aging is accompanied by a decline in the healthy function of multiple organ systems, leading to increased incidence and mortality from diseases such as type II diabetes mellitus, neurodegenerative diseases, cancer, and cardiovascular disease. Historically, researchers have focused on investigating individual pathways in isolated organs as a strategy to identify the root cause of a disease, with hopes of designing better drugs. Studies of aging in yeast led to the discovery of a family of conserved enzymes known as the sirtuins, which affect multiple pathways that increase the life span and the overall health of organisms. Since the discovery of the first known mammalian sirtuin, SIRT1, 10 years ago, there have been major advances in our understanding of the enzymology of sirtuins, their regulation, and their ability to broadly improve mammalian physiology and health span. This review summarizes and discusses the advances of the past decade and the challenges that will confront the field in the coming years.
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            AMPK and PPARdelta agonists are exercise mimetics.

            The benefits of endurance exercise on general health make it desirable to identify orally active agents that would mimic or potentiate the effects of exercise to treat metabolic diseases. Although certain natural compounds, such as reseveratrol, have endurance-enhancing activities, their exact metabolic targets remain elusive. We therefore tested the effect of pathway-specific drugs on endurance capacities of mice in a treadmill running test. We found that PPARbeta/delta agonist and exercise training synergistically increase oxidative myofibers and running endurance in adult mice. Because training activates AMPK and PGC1alpha, we then tested whether the orally active AMPK agonist AICAR might be sufficient to overcome the exercise requirement. Unexpectedly, even in sedentary mice, 4 weeks of AICAR treatment alone induced metabolic genes and enhanced running endurance by 44%. These results demonstrate that AMPK-PPARdelta pathway can be targeted by orally active drugs to enhance training adaptation or even to increase endurance without exercise.
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              Prevalence of the Metabolic Syndrome Among US Adults

                Author and article information

                Journal
                Diabetes
                Diabetes
                diabetes
                diabetes
                Diabetes
                Diabetes
                American Diabetes Association
                0012-1797
                1939-327X
                June 2012
                14 May 2012
                : 61
                : 6
                : 1315-1322
                Affiliations
                [1] 1Department of Medicine, Albert Einstein College of Medicine, Bronx, New York
                [2] 2Department of Genetics, Albert Einstein College of Medicine, Bronx, New York
                [3] 3Institute for Aging Research, Albert Einstein College of Medicine, Bronx, New York
                [4] 4Department of Pediatrics, Albert Einstein College of Medicine, Bronx, New York
                [5] 5Division of Endocrinology and Diabetes, Montefiore Medical Center, Bronx, New York
                [6] 6Department of Physiology, Southern Illinois University School of Medicine, Springfield, Illinois
                [7] 7Department of Internal Medicine, Southern Illinois University School of Medicine, Springfield, Illinois
                Author notes
                Corresponding author: Nir Barzilai, nir.barzilai@ 123456einstein.yu.edu .
                Article
                1300
                10.2337/db11-1300
                3357299
                22618766
                74f62792-caf5-4d4f-a286-26e42f863432
                © 2012 by the American Diabetes Association.

                Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. See http://creativecommons.org/licenses/by-nc-nd/3.0/ for details.

                History
                : 14 September 2011
                : 08 February 2012
                Categories
                Perspectives in Diabetes

                Endocrinology & Diabetes
                Endocrinology & Diabetes

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