Letter by Tsuda regarding article, Prediabetes and type 2 diabetes are associated with generalized microvascular dysfunction.
Letter by Tsuda regarding article, Prediabetes and type 2 diabetes are associated with generalized microvascular dysfunction.
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Tsuda 写的关于前驱糖尿病和 2 型糖尿病与全身微血管功能障碍相关的文章的信。
DOI：
10.1161/circulationaha.116.026309
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发表时间：
2017
期刊：
影响因子：
37.8
通讯作者：
Kazushi Tsuda
中科院分区：
文献类型：
--
作者：
Eriko Satomi;Hiromichi Matsuoka et al.;Hiromichi Matsuoka et al.;ｈHiromichi Matsuoka et al.;Hiromichi Matsuoka;Kazushi Tsuda;Kazushi Tsuda;Kazushi Tsuda;Kazushi Tsuda
我怀着极大的兴趣阅读了Sörensen及其同事1关于糖尿病前期和2型糖尿病受试者微血管功能障碍的文章。他们的研究结果表明，由闪烁光诱导的视网膜小动脉扩张和热诱导的皮肤充血决定的视网膜和皮肤微血管功能可能在前驱糖尿病中受损，并在2型糖尿病中进一步恶化。此外，作者还显示了血管收缩和微血管功能之间的负线性关系。这些发现支持了这样的假设，即广泛的微血管功能障碍可能先于2型糖尿病的临床诊断，并有助于2型糖尿病和前驱糖尿病中微血管并发症的发展，如视网膜病变、肾病、神经病变、心力衰竭、中风和认知能力下降。作者认为，早期高血糖和微血管功能障碍是减少糖尿病（前期）微血管并发症的潜在干预靶点，红细胞流变学特性与微循环障碍和微血管病变密切相关。Koscielny等2发现，与健康儿童相比，1型糖尿病儿童的皮肤和视网膜微循环的形态学改变，如静脉分支的扩张和刚性红细胞明显。最近，已经证明，通过双光镊拉伸技术确定的红细胞的变形性在患有2型糖尿病伴视网膜病变的受试者中显著低于正常健康对照受试者。3我们还用电子自旋共振方法观察了慢性肾脏病和肾病患者红细胞膜流动性的变化，发现红细胞膜流动性降低可能与肾小球滤过率和血浆一氧化氮代谢产物水平降低有关。4
I read with great interest the article by Sörensen and colleagues 1 dealing with the microvascular dysfunction in subjects with prediabetes and type 2 diabetes mellitus. The results of their study demonstrated that retina and skin microvascular function determined by flicker light–induced retinal arteriolar dilatation and heat-induced skin hyperemia might be impaired in prediabetes with further deterioration in type 2 diabetes mellitus. In addition, the authors showed the inverse linear associations between measures of glycemia and microvascular function. These findings support the hypothesis that generalized microvascular dysfunction might precede the clinical diagnosis of type 2 diabetes mellitus and contribute to the development of microvascular complications in type 2 diabetes mellitus and prediabetes such as retinopathy, nephropathy, neuropathy, heart failure, stroke, and cognitive decline. The authors proposed that both early hyperglycemia and microvascular dysfunction should be considered potential targets of intervention for reducing the microvascular complications in (pre) diabetes.Evidence indicates that erythrocyte rheological properties might be closely associated with disturbed microcirculation and microangiopathy. Koscielny et al 2 showed that morphological changes in the microcirculation of the skin and retina such as dilatations of venous branches and rigid erythrocytes were obvious in children with type 1 diabetes mellitus compared with healthy children. Recently, it has been demonstrated that the deformability of erythrocytes determined by a dual optical tweezers stretching technique was significantly lower in subjects with type 2 diabetes mellitus with retinopathy than in normal healthy control subjects. 3 We also observed changes in membrane fluidity of erythrocytes in chronic kidney disease and nephropathy by using an electron spin resonance method and found that reduced membrane fluidity of erythrocytes might be associated with decreased levels of estimated glomerular filtration rate and plasma nitric oxide metabolites. 4