Do genetic factors play a role in the pathogenesis of diabetic microangiopathy?
Do genetic factors play a role in the pathogenesis of diabetic microangiopathy?
复制标题
遗传因素在糖尿病微血管病变的发病机制中起作用吗？
作者：
Barbosa,J;Saner,B
结论目前尚无直接、确凿的证据表明遗传因素在糖尿病微血管病变的发病机制中起作用。人类白细胞抗原与并发症之间的关联已有报道，但没有得到一致的证实，这将为这些并发症的发生提供确凿的证据。另一方面，来自疾病及其并发症的自然病史研究和双胞胎研究的间接证据有力地表明，基因确实对小血管疾病的易感性起到了作用。提供这种易感性的最重要的基因可能与人类白细胞抗原无关。即使与代谢因素相比，总的遗传因素对微血管病变的易感性的贡献很小，但他们在疾病过程中的早期知识将发挥重要作用，识别需要更密集的糖尿病治疗以预防血管并发症的受试者。
ConclusionsThere is no direct and conclusive evidence that genetic factors play a role in the pathogenesis of microangiopathy in diabetes. Associations between HLA antigens and complications, which would contribute conclusive evidence of a genetic contribution to the genesis of these complications, have been reported but not consistently confirmed. On the other hand, circumstantial evidence from studies of the natural history of the disease and its complications and from twin studies strongly suggest that genes do contribute to the susceptibility to small vessel disease. The most important genes providing this susceptibility are probably unrelated to HLA. Even if the total genetic contribution to susceptibility for microangiopathy turns out to be small in comparison with that provided by metabolic factors, their knowledge early in the course of the disease would serve the important role of identifying subjects in need of more intensive diabetic management to prevent vascular complications.