The pathologic continuum of diabetic vascular disease.

The pathologic continuum of diabetic vascular disease.
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DOI:
10.1016/j.jacc.2008.09.055
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发表时间:
2009-02-03
影响因子:
24
通讯作者:
Plutzky, Jorge
Plutzky, Jorge
中科院分区:
医学1区
文献类型:
--
作者:
Orasanu, Gabriela;Plutzky, Jorge

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高血糖可通过多种机制促进血管并发症,晚期糖基化终产物(AGE)的形成和氧化应激的增加可能导致大血管和微血管并发症。许多对高血糖最早的病理反应都表现在直接遇到血糖水平升高的血管细胞中。在大血管系统中,这些细胞包括内皮细胞(EC)和血管平滑肌细胞(VSMC)。在微血管系统中,这些包括 EC、周细胞(在视网膜病变中)和足细胞(在肾脏疾病中)。此外,滋养管产生的新生血管可能促进动脉粥样硬化斑块进展并导致斑块破裂,从而将大血管病和微血管病联系起来。
Hyperglycemia can promote vascular complications by multiple mechanisms, with formation of advanced glycation endproducts (AGEs) and increased oxidative stress proposed to contribute to both macrovascular and microvascular complications. Many of the earliest pathologic responses to hyperglycemia are manifest in the vascular cells that directly encounter elevated blood glucose levels. In the macrovasculature, these include endothelial cells (ECs) and vascular smooth muscle cells (VSMCs). In the microvasculature, these include ECs, pericytes (in retinopathy), and podocytes (in renal disease). Additionally, neovascularization arising from the vasa vasorum may promote atherosclerotic plaque progression and contribute to plaque rupture, thereby interconnecting macro- and microangiopathy.
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