Low-intensity pulsed ultrasound ameliorates pancreatic injury and glucose metabolism in type 2 diabetic mice: regulatory role of the oxidative phosphorylation pathway.

Type 2 diabetes mellitus (T2DM) poses a significant global health challenge. While pharmacological interventions exist, increasing attention has been directed toward novel non-invasive therapeutic strategies. The pancreas plays a crucial role in T2DM pathogenesis, and its dysfunction is closely linked to mitochondrial abnormalities and oxidative stress. This study investigated the therapeutic potential of low-intensity pulsed ultrasound (LIPUS) on pancreatic protection in db/db mice, a model of T2DM. Mice were divided into sham-irradiated (db/db sham) and LIPUS-treated (db/db LIPUS) groups, with db/m mice as controls. The pancreatic region received daily LIPUS (0.37 MHz, 200 mW/cm2) for 45 days. Metabolic parameters, pancreatic histopathology, and ultrastructure were assessed alongside molecular analyses including proteomics and Western blot. LIPUS treatment significantly improved diabetic phenotypes, reducing random blood glucose (P < 0.05) and body weight (P < 0.05) while ameliorating islet hyperplasia and mitochondrial abnormalities. Importantly, LIPUS enhanced insulin sensitivity (homeostatic model assessment of insulin resistance reduction, P < 0.05) and reduced pancreatic apoptosis (BCL-2-associated X/B-cell lymphoma-2, P < 0.05) and oxidative stress (4-hydroxynonenal reduction, P < 0.05). Proteomic analysis revealed LIPUS-mediated regulation of energy metabolism pathways, particularly downregulation of oxidative phosphorylation components including cytochrome c oxidase subunit 7A2, ubiquinol-cytochrome c reductase core III subunit Q, and ATP synthase subunit O (all P < 0.05), confirmed by Western blot. These findings demonstrate that LIPUS alleviates pancreatic injury in diabetic mice primarily by modulating mitochondrial oxidative phosphorylation activity and subsequent oxidative damage. The study establishes LIPUS as a promising non-invasive therapeutic strategy for T2DM through its protective effects on pancreatic tissue, warranting further clinical investigation.