Diabetic Vasculopathy: Molecular Mechanisms and Clinical Insights.
Diabetic Vasculopathy: Molecular Mechanisms and Clinical Insights.
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糖尿病血管病变：分子机制与临床见解。
DOI：
10.3390/ijms25020804
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发表时间：
2024-01-09
影响因子：
5.6
通讯作者：
Sowers, James R.
中科院分区：
文献类型：
--
作者：
Jia, George;Bai, Hetty;Mather, Bethany;Hill, Michael A.;Jia, Guanghong;Sowers, James R.
临床和基础研究表明，高血糖和胰岛素抵抗/高胰岛素血症不仅构成代谢紊乱，导致心脏代谢综合征，而且容易引发糖尿病血管病变，糖尿病血管病变是指糖尿病引起的微血管和大血管并发症，包括视网膜病变、神经病变、动脉粥样硬化、冠状动脉疾病、高血压和外周动脉疾病。潜在的分子和细胞机制包括肾素血管紧张素-醛固酮系统的不当激活、线粒体功能障碍、过度氧化应激、炎症、血脂异常和血栓形成。这些异常共同促进代谢紊乱并进一步促进糖尿病血管病变。最近的证据表明，内皮祖细胞功能障碍、肠道生态失调以及细胞外囊泡及其携带的 microRNA 的异常释放也会导致糖尿病血管病变的发生和进展。因此，糖尿病的临床控制和治疗以及开发新的治疗策略对于预防心脏代谢综合征和相关的糖尿病血管病变至关重要。本综述重点关注糖尿病血管病变和相关心血管疾病中胰岛素抵抗与糖尿病之间的关系，重点介绍流行病学和临床特征、病理生理学和分子机制以及管理策略。
Clinical and basic studies have documented that both hyperglycemia and insulin-resistance/hyperinsulinemia not only constitute metabolic disorders contributing to cardiometabolic syndrome, but also predispose to diabetic vasculopathy, which refers to diabetes-mellitus-induced microvascular and macrovascular complications, including retinopathy, neuropathy, atherosclerosis, coronary artery disease, hypertension, and peripheral artery disease. The underlying molecular and cellular mechanisms include inappropriate activation of the renin angiotensin–aldosterone system, mitochondrial dysfunction, excessive oxidative stress, inflammation, dyslipidemia, and thrombosis. These abnormalities collectively promote metabolic disorders and further promote diabetic vasculopathy. Recent evidence has revealed that endothelial progenitor cell dysfunction, gut dysbiosis, and the abnormal release of extracellular vesicles and their carried microRNAs also contribute to the development and progression of diabetic vasculopathy. Therefore, clinical control and treatment of diabetes mellitus, as well as the development of novel therapeutic strategies are crucial in preventing cardiometabolic syndrome and related diabetic vasculopathy. The present review focuses on the relationship between insulin resistance and diabetes mellitus in diabetic vasculopathy and related cardiovascular disease, highlighting epidemiology and clinical characteristics, pathophysiology, and molecular mechanisms, as well as management strategies.
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影响因子：
4.3
作者：
Achim, Alexandru;Lacko, David;Huettl, Artur;Csobay-Novak, Csaba;Csavajda, Adam;Sotonyi, Peter;Merkely, Bela;Nemes, Balazs;Ruzsa, Zoltan
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Ruzsa, Zoltan
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44.5
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作者：
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通讯作者：
Criqui, Michael H.
影响因子：
16.2
作者：
Ford, ES
通讯作者：
Ford, ES
影响因子：
37.8
作者：
Devereux, RB;Dahlöf, B;Wachtell, K
通讯作者：
Wachtell, K