Altered mitochondrial metabolism in the insulin-resistant heart

Marina Makrecka-Kuka, Edgars Liepinsh, Andrew J. Murray, Hélène Lemieux, Maija Dambrova, Kersti Tepp, Marju Puurand, Tuuli Käämbre, Woo H. Han, Paul de Goede, Katie A. O'Brien, Belma Turan, Erkan Tuncay, Yusuf Olgar, Anabela P. Rolo, Carlos M. Palmeira, Neoma T. Boardman, Rob C.I. Wüst, Terje S. Larsen (Coresponding Author)

Research output: Contribution to journalReview articlepeer-review

52 Citations (Scopus)


Obesity-induced insulin resistance and type 2 diabetes mellitus can ultimately result in various complications, including diabetic cardiomyopathy. In this case, cardiac dysfunction is characterized by metabolic disturbances such as impaired glucose oxidation and an increased reliance on fatty acid (FA) oxidation. Mitochondrial dysfunction has often been associated with the altered metabolic function in the diabetic heart, and may result from FA-induced lipotoxicity and uncoupling of oxidative phosphorylation. In this review, we address the metabolic changes in the diabetic heart, focusing on the loss of metabolic flexibility and cardiac mitochondrial function. We consider the alterations observed in mitochondrial substrate utilization, bioenergetics and dynamics, and highlight new areas of research which may improve our understanding of the cause and effect of cardiac mitochondrial dysfunction in diabetes. Finally, we explore how lifestyle (nutrition and exercise) and pharmacological interventions can prevent and treat metabolic and mitochondrial dysfunction in diabetes.

Original languageEnglish
Article numbere13430
JournalActa Physiologica
Issue number3
Publication statusPublished - 1 Mar 2020
Externally publishedYes


  • diabetes
  • heart
  • lipotoxicity
  • mitochondria

Field of Science*

  • 3.1 Basic medicine

Publication Type*

  • 1.1. Scientific article indexed in Web of Science and/or Scopus database


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