VASCULAR REACTIVITY IN METABOLIC SYNDROME AND DIABETIC PATIENTS

代谢综合征和糖尿病患者的血管反应性

基本信息

批准号：
8362670
负责人：
ALBERT Edward CERUSSI
金额：
$ 0.51万
依托单位：
UNIVERSITY OF CALIFORNIA-IRVINE
依托单位国家：
美国
项目类别：
财政年份：
2011
资助国家：
美国
起止时间：
2011-04-01 至 2012-03-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8362670
关键词：
Ambulatory Care Facilities Biotechnology Blood Circulation Blood Glucose Blood Vessels Blood capillaries Blood flow Cardiovascular Diseases Caring Clinic Clinical Collaborations Defect Development Diabetes Mellitus Diagnosis Diffuse Disease Disease Progression Early Diagnosis Exposure to Funding Glucose Intolerance Grant Hemoglobin Institutes Insulin Resistance Lasers Lead Life Light Lipids Measures Metabolic Metabolic stress Metabolic syndrome Monitor Muscle National Center for Research Resources Nerve Neuropathy Optics Oxyhemoglobin Patient Monitoring Patients Perfusion Peripheral Nervous System Diseases Permeability Principal Investigator Property Protocols documentation Research Research Infrastructure Research Project Grants Resources Risk Screening procedure Source Spectrum Analysis Structure Techniques Time Tissues United States National Institutes of Health Water absorption capillary cardiovascular disorder risk cardiovascular risk factor cost deoxyhemoglobin diabetic diabetic patient malignant breast neoplasm new technology response tool

项目摘要

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. Primary support for the subproject and the subproject's principal investigator may have been provided by other sources, including other NIH sources. The Total Cost listed for the subproject likely represents the estimated amount of Center infrastructure utilized by the subproject, not direct funding provided by the NCRR grant to the subproject or subproject staff. Metabolic Syndrome is a highly prevalent condition that is comprised of several major clustering factors that increase the risk for developing cardiovascular disease (CVD). [41-43] The hallmarks of Metabolic Syndrome are discussed later in the protocol, however, insulin resistance, glucose intolerance, and/or Diabetes Mellitus (DM) are contributing factors to a diagnosis of Metabolic Syndrome. However, if the patient has DM alone, then he/she is still at risk for developing CVD, as insulin resistance on its own is associated with vascular changes. [38, 39] These disturbances can be seen down to the level of the microvasculature. Further, these vascular disturbances also lead to nerve damage and neuropathy. Diabetic Peripheral Neuropathy (DPN) is a condition brought on by prolonged exposure to high blood glucose. Interestingly, neuropathy can also modulate vascular reactivity and hence alter circulation. [44] Thus, it is important to monitor microvascular changes in patients to assess their disease progression and cardiovascular risks. Microvascular disturbances include abnormalities in arteriolar reactivity, capillary recruitment, permeability, and blood flow. [45] These changes are evident in both Metabolic Syndrome and DM patients. There are varying degrees of these disruptions, and the defects in small vessel structure and function can be observed very early in life and early in disease. [45] Therefore screening for microvascular changes in patients predisposed to the development of DM, Metabolic Syndrome, or CVD should provide a means to evaluate both progression towards a given disease state as well as the advancement of that disease. Thus, studying microvascular changes in patients may be of clinical importance in diseased patients as well as at-risk patients; however, there are no established, non-invasive, accurate, and easy ways to measure these changes at clinics. A tool that would allow clinicians to non-invasively measure changes in the microvasculature (for example, by quantifying the change in concentrations of deoxyhemoglobin and oxyhemoglobin in the microvasculature in response to metabolic stress) in an outpatient clinic, could allow for earlier detection and long-term monitoring of patients. This would allow more time for preventative care and treatment. This research project, in collaboration with partners at the Beckman Laser Institute, aims to evaluate the hypothesis that a novel technology known as Diffuse Optical Spectroscopy (DOS) can be used to non-invasively measure changes in the microvasculature of patients. DOS is a technique that measures the optical absorption and scattering properties of near-infrared light in tissues such as muscle in order to quantify the absolute concentration of oxygenated and deoxygenated hemoglobin, water, and lipids. It provides quantitative and functional information on the microvasculature related to tissue perfusion, metabolic changes, and indicators of tissue damage. It has shown promise in the field of breast cancer, and we seek to evaluate the potential of DOS as a means to measure microvascular changes in Metabolic Syndrome and DM patients in order to assess CVD risk.

该副本是利用资源的众多研究子项目之一由NIH/NCRR资助的中心赠款提供。对该子弹的主要支持而且，副投影的主要研究员可能是其他来源提供的包括其他NIH来源。列出的总费用可能代表subproject使用的中心基础架构的估计量， NCRR赠款不直接向子弹或副本人员提供的直接资金。代谢综合征是一种高度普遍的疾病，由几个主要的聚类因素组成，这些因素增加了患心血管疾病（CVD）的风险。 [41-43]稍后在协议中讨论了代谢综合征的标志，但是，胰岛素抵抗，葡萄糖不耐症和/或糖尿病（DM）是诊断代谢综合征的促成因素。但是，如果患者只有DM，然后他/她仍有患CVD的风险，因为胰岛素耐药性本身与血管变化有关。 [38，39]这些干扰可以看到到微脉管系统的水平。此外，这些血管障碍还导致神经损伤和神经病。糖尿病周围神经病（DPN）是长期暴露于高血糖所带来的疾病。有趣的是，神经病还可以调节血管反应性，从而改变循环。 [44]因此，监测患者的微血管变化很重要，以评估其疾病进展和心血管风险。微血管干扰包括小动脉反应性，毛细血管募集，渗透性和血流的异常。 [45]这些变化在代谢综合征和DM患者中都是明显的。这些干扰有不同程度，小容器结构中的缺陷和可以在疾病的早期和早期就可以观察到功能。 [45]因此，筛查易受DM，代谢综合征或CVD发展的患者的微血管变化，应提供一种评估对特定疾病状态的进展的方法以及该进步的进展疾病。因此，研究患者的微血管变化可能在患者和高危患者中具有临床重要性。但是，没有建立，无创，准确且简单的方法来衡量诊所的这些变化。一种可以使临床医生能够非侵入性测量微脉管系统的变化的工具（例如，通过量化响应代谢压力的微拥抱症中的脱氧血红蛋白和氧气蛋白的浓度变化）在门诊临床中可以允许早期检测和长期监测患者的长期监测。这将为预防性提供更多时间护理和治疗。该研究项目与贝克曼激光研究所（Beckman Laser Institute）的合作伙伴合作，旨在评估以下假设：一种称为弥漫性光学光谱法（DOS）的新技术可用于非侵入性测量患者微胚胎的变化。 DOS是一种测量的技术肌肉等组织中近红外光的光吸收和散射特性，以量化氧化和去氧的血红蛋白，水和脂质的绝对浓度。它提供了有关与组织灌注，代谢变化和组织损伤指标有关的微脉管系统的定量和功能信息。它在乳腺癌领域表现出了希望，我们试图评估DOS作为测量代谢综合征和DM患者微血管变化的一种手段，以评估CVD风险。