Effects and mechanisms of <italic style="font-style: italic">Astragalus</italic> polysaccharide in diabetes mellitus and its chronic complications

HE Yiqian; QU Ling

doi:10.16025/j.1674-1307.2025.07.026

您当前的位置：

首页 >

文章列表页 >

Effects and mechanisms of Astragalus polysaccharide in diabetes mellitus and its chronic complications

更新时间：2025-09-11

- Effects and mechanisms of Astragalus polysaccharide in diabetes mellitus and its chronic complications
- Beijing Journal of Traditional Chinese Medicine Vol. 44, Issue 7, Pages: 934-940(2025)
- 作者机构：
  
  中国医学科学院北京协和医学院北京协和医院中医科，北京 100730
- 作者简介：
- 基金信息：
- DOI：10.16025/j.1674-1307.2025.07.026
  CLC：
- Received：28 May 2024，
  
  Published：25 July 2025
- 稿件说明：
移动端阅览
何怡芊，屈岭.黄芪多糖对糖尿病及其慢性并发症的影响及机制研究进展［J］.北京中医药，2025，44（7）：934-940.

HE Yiqian,QU Ling.Effects and mechanisms of Astragalus polysaccharide in diabetes mellitus and its chronic complications[J]. Beijing Journal of Traditional Chinese Medicine,2025,44(07):934-940.
何怡芊，屈岭.黄芪多糖对糖尿病及其慢性并发症的影响及机制研究进展［J］.北京中医药，2025，44（7）：934-940. DOI： 10.16025/j.1674-1307.2025.07.026.

HE Yiqian,QU Ling.Effects and mechanisms of Astragalus polysaccharide in diabetes mellitus and its chronic complications[J]. Beijing Journal of Traditional Chinese Medicine,2025,44(07):934-940. DOI： 10.16025/j.1674-1307.2025.07.026.

摘要

糖尿病及其慢性并发症是重要的公共卫生问题。近年来研究发现黄芪多糖在防治糖尿病及其慢性并发症方面具有积极作用。黄芪多糖主要从两方面影响糖尿病的进展：一方面，黄芪多糖通过激活磷脂酰肌醇三激酶/蛋白激酶B（PI3K/Akt）信号通路，或抑制微小RNA的表达，从而改善胰岛β细胞的活力和功能，促进胰岛素分泌，抑制血糖升高；另一方面，黄芪多糖通过激活PI3K/Akt信号通路或信号转导及转录激活蛋白（STAT5）促进肝脏和骨骼肌对葡萄糖的吸收、利用与转化，改善胰岛素抵抗。黄芪多糖对糖尿病视网膜病变的作用机制可能是通过影响微小RNA的表达，干预靶蛋白沉默信息调节因子1（SIRT1）、蛋白激酶R样内质网激酶（PERK）和肌醇需求酶1（IRE1）、转录因子6（ATF6）信号通路蛋白表达，或调控Akt-血管内皮生长因子（VEGF）信号通路，影响视网膜新生血管生成，进而保护视网膜色素上皮细胞；黄芪多糖可通过调节肾素-血管紧张素系统（RAS）、改善肾脏病理变化，或作用于腺苷酸活化蛋白激酶（AMPK）/SIRT1等信号通路，减轻肾脏损伤、抗炎等作用机制，抑制糖尿病肾病发生发展；黄芪多糖能够通过多种作用途径改善糖尿病心肌病，主要包括抗氧化应激、减轻内质网应激、促进自噬以及调控骨形态发生蛋白10（BMP10）相关信号等机制，从而保护心肌细胞、抑制心室重构，改善心脏功能和血流动力学；另外，黄芪多糖在糖尿病溃疡、糖尿病肌少症、糖尿病血管内皮病变和糖尿病认知功能障碍的防治中亦发挥积极作用。

Abstract

Diabetes mellitus and its chronic complications are important public health concerns. Recent studies have shown that

Astragalus

polysaccharide （APS） plays an active role in the prevention and treatment of diabetes mellitus and its chronic complications. APS primarily affects diabetes progression through two mechanisms. First， it improves the viability and function of pancreatic β-cells by activating the phosphoinositide 3-kinase/protein kinase B （PI3K/Akt） signaling pathway or inhibiting microRNA expression， thereby promoting insulin secretion and reducing hyperglycemia. Second， APS improves insulin resistance by promoting glucose uptake， utilization， and transformation in the liver and skeletal muscle via activation of the PI3K/Akt or signal transducer and activator of transcription 5 （STAT5） pathways. In diabetic retinopathy， APS may act by regulating microRNA expression and modulating pathways involving silent information regulator 1 （SIRT1）， protein kinase R-like endoplasmic reticulum kinase （PERK）， inositol-requiring enzyme 1 （IRE1）， and activating transcription factor 6 （ATF6）， or by regulating the Akt-vascular endothelial growth factor （VEGF） axis， thereby inhibiting retinal neovascularization and protecting retinal pigment epithelial cells. In diabetic nephropathy， APS may alleviate renal injury and inflammation by modulating the renin-

angiotensin system （RAS）， improving pathological changes of the kidneys， or activating AMP-activated protein kinase （AMPK）/SIRT1 signaling pathway， thus preventing disease progression. APS also protects against diabetic cardiomyopathy through multiple mechanisms， including antioxidant effects， attenuation of endoplasmic reticulum stress， promotion of autophagy， and regulation of bone morphogenetic protein 10 （BMP10）-related signaling， thereby protecting cardiomyocytes， preventing ventricular remodeling， and improving cardiac function and hemodynamics. In addition， APS demonstrates therapeutic potential in diabetic ulcers， diabetic sarcopenia， vascular endothelial dysfunction， and diabetes-associated cognitive impairment.

关键词

Keywords

references

OGURTSOVA K , GUARIGUATA L , BARENGO NC , et al . IDF diabetes atlas:global estimates of undiagnosed diabetes in adults for 2021 [J ] . Diabetes Res Clin Pract , 2022 , 183 : 109118 .

贾伟平 . 对我国糖尿病并发症防治的战略思考 [J ] . 中华糖尿病杂志 , 2019 , 11 ( 8 ): 505 - 507 .

Umanath K , Lewis JB . Update on diabetic nephropathy:core curriculum 2018 [J ] . Am J Kidney Dis , 2018 , 71 ( 6 ): 884 - 895 .

高昕媛 , 徐倩 , 匡洪宇 . 《糖尿病相关眼病防治多学科中国专家共识》(2021年版)解读 [J ] . 临床内科杂志 , 2022 , 39 ( 5 ): 306 - 309 .

吴春兴 , 孟梅 , 刘海亮 , 等 . 《消渴病古今名家验案全析》中糖尿病组方规律研究 [J ] . 中央民族大学学报(自然科学版) , 2024 , 33 ( 3 ): 81 - 88 .

徐程 , 高哲涵 , 李崇超 . 基于数据挖掘的《太平圣惠方》治疗消渴病用药规律研究 [J ] . 现代中西医结合杂志 , 2023 , 32 ( 21 ): 3013 - 3017 .

LIU Y , YU R , WANG X , et al . Research progress of the effective active ingredients of Astragalus mongholicus in the treatment of diabetic peripheral neuropathy [J ] . Biomed Pharmacother , 2024 , 173 : 116350 .

ZHENG Y , REN W , ZHANG L , et al . A review of the pharmacological action of astragalus polysaccharide [J ] . Front Pharmacol , 2020 , 11 : 349 .

TANG Z , HUANG G . Extraction,structure,and activity of polysaccharide from Radix astragali [J ] . Biomed Pharmacother , 2022 , 150 : 113015 .

周广举 , 李宜臻 , 彭雅茗 , 等 . 黄芪多糖注射液对糖尿病肾病患者尿液CXCL10、E-cadherin及MMP-9水平的影响 [J ] . 解放军医药杂志 , 2021 , 33 ( 1 ): 94 - 97 .

LUO MJ , WANG Y , CHEN SY , et al . Astragalus polysaccharides alleviate type 2 diabetic rats by reversing the expressions of sweet taste receptors and genes related to glycolipid metabolism in liver [J ] . Front Pharmacol , 2022 , 13 : 916603 .

沙雯君 , 徐碧林 , 申甜 , 等 . 黄芪多糖对糖尿病大鼠胰岛功能及血清胰高血糖素样肽-1水平的影响 [J ] . 世界临床药物 , 2022 , 43 ( 3 ): 243 - 247 .

高攀攀 , 李盼盼 , 蔡晓萌 . 黄芪多糖通过PI3K/Akt途径抑制小鼠胰岛βTC-6细胞凋亡的机制研究 [J ] . 营养学报 , 2019 , 41 ( 3 ): 265 - 269 .

DENG S , YANG L , MA K , et al . Astragalus polysaccharide improve the proliferation and insulin secretion of mouse pancreatic beta cells induced by high glucose and palmitic acid partially through promoting miR-136-5p and miR-149-5p expression [J ] . Bioengineered , 2021 , 12 ( 2 ): 9872 - 9884 .

WU J , XU X , DUAN J , et al . EFHD2 suppresses intestinal inflammation by blocking intestinal epithelial cell TNFR1 internalization and cell death [J ] . Nat Commun , 2024 , 15 ( 1 ): 1282 .

中华医学会糖尿病学分会 . 中国2型糖尿病防治指南（2020年版） [J ] . 中华糖尿病杂志 , 2021 , 13 ( 4 )： 315 - 409 .

RACHDAOUI N . Insulin:the friend and the foe in the development of type 2 diabetes mellitus [J ] . Int J Mol Sci , 2020 , 21 ( 5 ): 1770 .

吴英萍 , 张永杰 , 杨文奎 . 黄芪多糖联用胰岛素对糖尿病大鼠胰岛素抵抗的作用机制研究 [J ] . 中国临床药理学杂志 , 2020 , 36 ( 13 ): 1830 - 1832,1841 .

ZHAO H , ZHAI BW , ZHANG MY , et al . Phlorizin from Lithocarpus litseifolius [Hance] Chun ameliorates FFA-induced insulin resistance by regulating AMPK/PI3K/AKT signaling pathway [J ] . Phytomedicine , 2024 , 130 : 155743 .

SANTOLERI D , TITCHENELL PM . Resolving the paradox of hepatic insulin resistance [J ] . Cell Mol Gastroenterol Hepatol , 2019 , 7 ( 2 ): 447 - 456 .

ZHOU K , XIAO S , CAO S , et al . Improvement of glucolipid metabolism and oxidative stress via modulating PI3K/Akt pathway in insulin resistance HepG2 cells by chickpea flavonoids [J ] . Food Chem X , 2024 , 23 : 101630 .

向胡蝶 . 黄芪多糖对2型糖尿病胰岛素抵抗小鼠的作用研究 [D ] . 宜昌 : 三峡大学 , 2022 .

邓涛 , 田敏 , 黄宏耀 . 黄芪多糖的胰岛素增敏作用及对蛋白激酶B核转位影响 [J ] . 湖北中医药大学学报 , 2020 , 22 ( 4 ): 22 - 25 .

SESTI G , SCIACQUA A , CARDELLINI M , et al . Plasma concentration of IGF-I is independently associated with insulin sensitivity in subjects with different degrees of glucose tolerance [J ] . Diabetes Care , 2005 , 28 ( 1 ): 120 - 125 .

YUE X , HAO W , WANG M , et al . Astragalus polysaccharide ameliorates insulin resistance in HepG2 cells through activating the STAT5/IGF-1 pathway [J ] . Immun Inflamm Dis , 2023 , 11 ( 11 ): 1071 .

VUJOSEVIC S , ALDINGTON SJ , SILVA P , et al . Screening for diabetic retinopathy:new perspectives and challenges [J ] . Lancet Diabetes Endocrinol , 2020 , 8 ( 4 ): 337 - 347 .

LIU DD , ZHANG CY , ZHANG JT , et al . Epigenetic modifications and metabolic memory in diabetic retinopathy:beyond the surface [J ] . Neural Regen Res , 2023 , 18 ( 7 ): 1441 - 1449 .

GAO LM , FU S , LIU F , et al . Astragalus polysaccharide regulates miR-182/Bcl-2 axis to relieve metabolic memory through suppressing mitochondrial damage-mediated apoptosis in retinal pigment epithelial cells [J ] . Pharmacology , 2021 , 106 ( 9-10 ): 520 - 533 .

LIU P , PENG QH , TONG P , et al . Astragalus polysaccharides suppresses high glucose-induced metabolic memory in retinal pigment epithelial cells through inhibiting mitochondrial dysfunction-induced apoptosis by regulating miR-195 [J ] . Mol Med , 2019 , 25 ( 1 ): 21 .

PENG QH , TONG P , GU LM , et al . Astragalus polysaccharide attenuates metabolic memory-triggered ER stress and apoptosis via regulation of miR-204/SIRT1 axis in retinal pigment epithelial cells [J ] . Biosci Rep , 2020 , 40 ( 1 ): BSR20192121 .

闫丰华 , 焦禄安 , 郑加军 , 等 . 黄芪多糖对糖尿病模型大鼠视网膜病变及血清胱抑素C的影响 [J ] . 热带医学杂志 , 2019 , 19 ( 7 ): 813 - 816, 后插2.

CAMPOCHIARO PA . Molecular pathogenesis of retinal and choroidal vascular diseases [J ] . Prog Retin Eye Res , 2015 , 49 : 67 - 81 .

郝艳 , 周志华 . 血清胱抑素C与2型糖尿病视网膜病变及周围血管病变相关性分析 [J ] . 临床军医杂志 , 2020 , 48 ( 1 ): 84 - 86 .

UMANATH K , LEWIS JB . Update on diabetic nephropathy:core curriculum 2018 [J ] . Am J Kidney Dis , 2018 , 71 ( 6 ): 884 - 895 .

NAAMAN SC , BAKRIS GL . Diabetic nephropathy:update on pillars of therapy slowing progression [J ] . Diabetes Care , 2023 , 46 ( 9 ): 1574 - 1586 .

肖顺强 , 李佑生 , 卞伟 , 等 . 黄芪组分对糖尿病肾病大鼠循环及肾脏局部肾素-血管紧张素系统的影响 [J ] . 广州中医药大学学报 , 2021 , 38 ( 9 ): 1933 - 1940 .

SELBY NM , TAAL MW . An updated overview of diabetic nephropathy:diagnosis,prognosis,treatment goals and latest guidelines [J ] . Diabetes Obes Metab , 2020 , 22 ( 1 ): 3 - 15 .

李丹丹 , 刘佳佳 , 刘军军 , 等 . 黄芪多糖联合二甲双胍对衰老2型糖尿病小鼠肾组织糖原代谢及超微结构的影响 [J ] . 时珍国医国药 , 2019 , 30 ( 4 ): 827 - 829 .

魏瑞贤 , 杨丽霞 , 崔阳阳 , 等 . 黄芪多糖对糖尿病肾病小鼠肾组织血管内皮损伤的影响 [J ] . 中国临床药理学杂志 , 2023 , 39 ( 21 ): 3130 - 3133 .

SHATI AA . Salidroside ameliorates diabetic nephropathy in rats by activating renal AMPK/SIRT1 signaling pathway [J ] . J Food Biochem , 2020 , 44 ( 4 ): 13158 .

刘旭峰 , 冯佳 , 王述进 , 等 . 黄芪多糖对糖尿病肾病大鼠氧化应激和自噬的影响及机制 [J ] . 山西医科大学学报 , 2023 , 54 ( 3 ): 343 - 351 .

徐雪垠 . 黄芪多糖通过AMPK/SIRT1/PGC-1α途径对糖尿病肾病肾小管上皮细胞线粒体的影响 [J ] . 山东医药 , 2020 , 60 ( 5 ): 33 - 37 .

张熙 , 郑俊威 , 潘雪莲 , 等 . 黄芪多糖通过抑制炎性因子改善糖尿病大鼠肾损伤 [J ] . 湖北医药学院学报 , 2020 , 39 ( 5 ): 438 - 442, 封 3 .

DILLMANN WH . Diabetic cardiomyopathy [J ] . Circ Res , 2019 , 124 ( 8 ): 1160 - 1162 .

MURTAZA G , VIRK H , KHALID M , et al . Diabetic cardiomyopathy：a comprehensive updated review [J ] . Prog Cardiovasc Dis , 2019 , 62 ( 4 ): 315 - 326 .

SUN S , YANG S , ZHANG N , et al . Astragalus polysaccharides alleviates cardiac hypertrophy in diabetic cardiomyopathy via inhibiting the BMP10-mediated signaling pathway [J ] . Phytomedicine , 2023 , 109 : 154543 .

叶婷 , 陈晶 , 马国庆 , 等 . 黄芪多糖对糖尿病心肌病大鼠自噬的调控机制研究 [J ] . 时珍国医国药 , 2022 , 33 ( 2 ): 312 - 316 .

孙奇林 , 陈雯洁 , 杨叶虹 , 等 . 黄芪多糖改善高糖诱导的H9C2心肌细胞氧化应激损伤的机制研究 [J ] . 老年医学与保健 , 2019 , 25 ( 5 ): 583 - 589 .

孙奇林 , 鞠婧 , 王浩 , 等 . 黄芪多糖干预糖尿病心肌氧化应激的实验研究 [J ] . 中国中西医结合杂志 , 2020 , 40 ( 2 ): 196 - 203 .

孙奇林 , 陈雯洁 , 赵雪兰 , 等 . 黄芪多糖下调心肌p38和核因子κB的磷酸化改善老年糖尿病鼠心脏功能 [J ] . 老年医学与保健 , 2021 , 27 ( 2 ): 399 - 404 .

王瑜 , 于瑞雪 , 胡思博 , 等 . 黄芪多糖对糖尿病心肌病模型大鼠的保护作用 [J ] . 中国临床药理学杂志 , 2019 , 35 ( 21 ): 2754 - 2758 .

BELALI OM , AHMED MM , MOHANY M , et al . LCZ696 protects against diabetic cardiomyopathy-induced myocardial inflammation,ER stress,and apoptosis through inhibiting AGEs/NF-κB and PERK/CHOP signaling pathways [J ] . Int J Mol Sci , 2022 , 23 ( 3 ): 1288 .

SUN S , YANG S , AN N , et al . Astragalus polysaccharides inhibits cardiomyocyte apoptosis during diabetic cardiomyopathy via the endoplasmic reticulum stress pathway [J ] . J Ethnopharmacol , 2019 , 238 : 111857 .

叶婷 , 马国庆 , 魏明慧 , 等 . 黄芪多糖对糖尿病心肌病大鼠AMPK-mTOR通路的调控机制研究 [J ] . 世界中医药 , 2022 , 17 ( 7 ): 977 - 982 .

侯赛红 , 孙树芹 , 徐万群 , 等 . 黄芪多糖对糖尿病心肌病大鼠心肌细胞凋亡的影响 [J ] . 青岛大学学报（医学版） , 2020 , 56 ( 3 ): 293 - 296 .

梁旭 , 贺波 , 赵文懿 , 等 . 黄芪多糖：壳聚糖/胶原组织工程支架在糖尿病大鼠皮肤缺损创面修复中的应用效果观察 [J ] . 山东医药 , 2021 , 61 ( 33 ): 48 - 52 .

孔一晗 , 刘信邦 , 常柏 , 等 . 黄芪多糖减轻糖尿病性肌少症大鼠肌肉萎缩的作用机制研究 [J ] . 天津中医药 , 2024 , 41 ( 1 ): 106 - 110 .

朱潇潇 . 黄芪多糖延缓血管内皮细胞衰老的作用及其机制探讨 [D ] . 北京 : 中国人民解放军医学院 , 2019 .

禹博威 , 潘晓琼 , 陈君第霞 , 等 . 黄芪多糖对糖尿病动脉粥样硬化大鼠糖脂代谢的影响及血管内皮保护机制 [J ] . 浙江中医药大学学报 , 2021 , 45 ( 5 ): 447 - 453 .

吴坚 , 付瑛 . 黄芪多糖联合格列美脲对链脲佐菌素诱导的糖尿病小鼠认知功能障碍的保护作用 [J ] . 药品评价 , 2021 , 18 ( 15 ): 909 - 913 .

李伯武 , 陈弘东 , 杨光耀 , 等 . 益消方治疗糖尿病周围神经病变气阴两虚兼瘀证的临床研究 [J ] . 北京中医药 , 2024 , 43 ( 9 ): 996 - 1000 .

刘德峰 , 刘爱茹 , 高娟娟 , 等 . 健脾益气活血汤联合阿仑膦酸钠治疗糖尿病合并骨质疏松症的疗效观察 [J ] . 北京中医药 , 2023 , 42 ( 10 ): 1069 - 1075 .

周洛卿 , 王友 , 贾晓蕾 , 等 . 补肾开玄通络方联合西药治疗G3a期糖尿病肾病的疗效观察 [J ] . 北京中医药 , 2024 , 43 ( 5 ): 551 - 554 .

HUANG X , LIU G , GUO J , et al . The PI3K/AKT pathway in obesity and type 2 diabetes [J ] . Int J Biol Sci , 2018 , 14 ( 11 ): 1483 - 1496 .

Views

下载量

CSCD

Alert me when the article has been cited

提交

Tools

Publicity Resources

Therapeutic effect and mechanism of Tangfukang Formula on KKAy diabetes mice

Traditional Chinese medicine treatment of idiopathic pulmonary fibrosis based on NLRP3 inflammasome: a review

Mechanism of acupuncture at Yaotong dian for renal colic caused by urinary calculi based on metabonomics

Observation on the curative effect of Jianpi Yiqi Huoxue Decoction combined with alendronate sodium in the treatment of diabetes mellitus complicated with osteoporosis

Research on the regulation and mechanism of Buzhong Yiqi Decoction for immune imbalance in experimental autoimmune thyroiditis rats

Related Author

FENG Xingzhong

LI Jianhui

WANG Wei

WANG Yan

YAN Kai

LYU Anqi

JIANG Cheng

ZUO Wanzhao

Related Institution

Endocrinology Department， Yuquan Hospital of Tsinghua University （Tsinghua University Integrated Traditional Chinese and Western Medicine Hospital）

Department of Traditional Chinese Medicine， Civil Aviation General Hospital

Department of Traditional Chinese Medicine， Beijing Chaoyang Hospital Affiliated to Capital Medical University

Hubei Provincial Hospital of TCM/Hubei Shizhen Laboratory/Affiliated Hospital of Hubei University of Chinese Medicine

College of Traditional Chinese Medicine（TCM），Hubei University of Chinese Medicine

⁰

Effects and mechanisms of Astragalus polysaccharide in diabetes mellitus and its chronic complications

DOI：10.16025/j.1674-1307.2025.07.026

摘要

Abstract

关键词

Keywords

references