The Vasculature in Prediabetes.
The Vasculature in Prediabetes.
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DOI：
10.1161/circresaha.118.311912
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发表时间：
2018-04-13
影响因子：
20.1
通讯作者：
Brown NJ
中科院分区：
文献类型：
--
作者：
Wasserman DH;Wang TJ;Brown NJ
糖尿病前期的频率随着肥胖症在全世界范围内的流行而增加。在糖尿病前期，高血糖症、胰岛素抵抗、炎症和代谢紊乱与伴随肥胖引起内皮血管扩张和纤维蛋白溶解功能障碍，导致心血管和肾脏疾病的风险增加。重要的是，微血管系统通过影响胰岛素和葡萄糖向骨骼肌的递送而影响胰岛素敏感性;因此，内皮功能障碍和细胞外基质重塑促进从前驱糖尿病向糖尿病的进展。减肥是糖尿病前期治疗的主要手段，但改善内皮功能和血管舒张的疗法不仅可以预防心血管疾病，还可以减缓糖尿病的进展。
The frequency of prediabetes is increasing as the prevalence of obesity rises worldwide. In prediabetes, hyperglycemia, insulin resistance, and inflammation and metabolic derangements associated with concomitant obesity cause endothelial vasodilator and fibrinolytic dysfunction, leading to increased risk of cardiovascular and renal disease. Importantly, the microvasculature impacts on insulin sensitivity by affecting the delivery of insulin and glucose to skeletal muscle; thus, endothelial dysfunction and extracellular matrix remodeling promote the progression from prediabetes to diabetes. Weight loss is the mainstay of treatment in prediabetes, but therapies that improved endothelial function and vasodilation may not only prevent cardiovascular disease but also slow progression to diabetes.