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Diabetes-associated macrovasculopathy: pathophysiology and pathogenesis   总被引:1,自引:0,他引:1  
The complications associated with diabetic vasculopathy are commonly grouped into two categories: microvascular and macrovascular complications. In diabetes, macrovascular disease is the commonest cause of mortality and morbidity and is responsible for high incidence of vascular diseases such as stroke, myocardial infarction and peripheral vascular diseases. Macrovascular diseases are traditionally thought of as due to underlying obstructive atherosclerotic diseases affecting major arteries. Pathological changes of major blood vessels leading to functional and structural abnormalities in diabetic vessels include endothelial dysfunction, reduced vascular compliance and atherosclerosis. Besides, advanced glycation end product formation interacts with specific receptors that lead to overexpression of a range of cytokines. Haemodynamic pathways are activated in diabetes and are possibly amplified by concomitant systemic hypertension. Apart from these, hyperglycaemia, non-enzymatic glycosylation, lipid modulation, alteration of vasculature and growth factors activation contribute to development of diabetic vasculopathy. This review focuses on pathophysiology and pathogenesis of diabetes-associated macrovasculopathy.  相似文献
2.
Riassunto E' stata studiata l'assunzione di glucosioin vitro da parte di frammenti d'arteria provenienti da animali o da uomo, affetto e non affetto, da diabete mellito. Le arterie provenienti da uomo non diabetico assumono in genere meno glucosio rispetto alla arteria proveniente da bovini. Tali differenze si riducono se le arterie umane vengono private dell'avventizia. Le arterie umane non diabetiche assumono più glucosio nei confronti delle arterie provenienti da soggetti affetti da diabete mellito. Mentre l'incubazione con plasma umano normale aumenta nettamente l'assunzione di glucosio in tutte le arterie di uomo diabetico e non, essa non determina significativi miglioramenti della'assunzione di glucosio da parte dei frammenti di arterie bovine. L'aggiunta di insulina cristallizzata di bue al liquido di incubazione delle arterie umane non induce significativi incrementi dell'assunzione di glucosio se non a concentrazioni di 2 mU/ml nell'incubazione di arterie umane private dell'avventizia.
Summary The AA. have studied thein vitro glucose uptake by fragments derived from animals and from humans, both diabetic and non-diabetic. The arteries derived from non-diabetic humans generally assume less glucose than those derived from oxen. Such differences decrease if the human arteries are deprived of theadventitia. The human non-diabetic arteries assume more glucose than those derived from subjects suffering from diabetes mellitus. While incubation with normal human plasma clearly increases the glucose uptake in all the arteries of man, both diabetic and not, it does not cause significant improvements in the glucose uptake by the fragments of bovine arteries. The addition of crystallized ox insulin to the incubation liquid of the human arteries does not cause significant improvements in the glucose uptake except at 2 mU/ml, when human arteries deprived of theadventitia are used.

Zusammenfassung Es wurde die Aufnahme von Glukosein vitro durch Arterien-Fragmente von Tieren oder Menschen mit oder ohne Diabetes mellitus untersucht. Die Arterien von nicht diabetischen Menschen nehmen im allgemeinen weniger Glukose auf, als die Arterien von Rindern. Diese Unterschiede werden geringer, wenn man den Humanarterien dieadventitia entzieht. Die Arterien von nicht diabetischen Menschen nehmen mehr Glukose auf, als die Arterien von Menschen mit Diabetes mellitus. Während die Inkubation mit normalem Humanplasma die Glukoseaufnahme in allen Arterien von Menschen mit oder ohne Diabetes klar steigert, bewirkt sie keine signifikante Verbesserung der Glukose-Aufnahme durch Arterien-Fragmente von Rindern. Der Zusatz von kristallisiertem Rinderinsulin zur Inkubations-Flüssigkeit der Human-Arterien induziert keine signifikanten Zunahmen der Glukoseaufnahme, es sei denn mit einer Konzentration von 2 mE/ml bei der Inkubation von Humanarterien ohneadventitia.

Resumen Se estudió la captación de glucosain vitro de parte de fragmentos de arteria procedentes de animales o de hombres afectos y no de diabetes mellitus. En general, las arterias del hombre no diabético captan menos glucosa que las de los bovinos. Estas diferencias se reducen si se privan a las arterias humanas de la adventicia. Las arterias humanas no diabéticas captan más glucosa que las arterias de sujetos afectos de diabetes mellitus. Mientras la incubación con plasma humano normal aumenta netamente la captación de glucosa en todas las arterias del hombre diabético y no, la misma no determina mejorías significativas de la captación de glucosa de parte de los fragmentos de arterias bovinas. La adición de insulina cristalizada de buey al líquido de incubación de las arterias humanas no produce aumentos significativos en la captación de glucosa sino a concentraciones de 2 mU/ml en la incubación de arterias humanas sin adventicia.

Resume Les AA. ont étudié l'assimilation de glucosein vitro par des fragments d'artère provenantes de animaux ou de sujets atteints ou non de diabète sucré. Les artères des sujets non diabétiques assument en général moins glucose que les artères d'origine bovine. Cettes différences sont réduites si les artères humaines sont privées de l'adventice. Les artères humaines non diabétiques assument plus glucose que les artères provenantes de sujets atteints de diabète sucré. Tandis que l'incubation avec du sérum humain normal augmente nettement l'assimilation du glucose dans toutes les artères du sujet diabétique et non diabétique, elle ne porte pas des améliorations significatives dans l'assimilation du glucose par les fragments des artères bovines. L'addition d'insuline cristallisée du boeuf au liquide d'incubation des artères humaines ne porte pas des augmentations significatives de l'assimilation du glucose, si non avec des concentrations de 2 mU/ml dans l'incubation des artères humaines privées de l'adventice.
  相似文献
3.
Summary Serum and urinary activities of two acid glycohydrolases, beta-n-acetyl-glucosaminidase and beta-glucuronidase, were significantly higher in a group of diabetic patients when compared to a control group. No significant differences were found between patients without vascular complications and those with retinopathy and/or large vessel disease, while the highest enzyme levels were present in diabetics in poor metabolic control. In diabetics with nephropathy, urinary excretion of both enzymes was further increased, so that the serum/urine activity ratio (>1 in normal subjects and in diabetics without nephropathy) was inverted (<1). These data seem to show that the high activity of these enzymes, commonly observed in diabetes mellitus, is related to the illness rather than to its vascular complications, being higher in patients in poor metabolic control. Furthermore serum/urine activity ratio may be a useful indicator in the monitoring of diabetic nephropathy.  相似文献
4.
In the history of diabetes, chlorpropamide alcohol flushing test (CPAF) was a big topic in the 1970s to 1980s. Alcohol tolerance after chlorpropamide has prognostic significance, with the intolerant group (CPAF-positive group) being less prone to develop vascular complication than the tolerant group (CPAF-negative group). A mechanism of CPAF has been regarded as the inhibition of aldehyde dehydrogenase 2 (ALDH2) by an N1-alkyl-substituted derivative of chlorpropamide, and the expression of these mutations of ALDH2 and alcohol dehydrogenase 2 (ADH2) could determine the alcohol tolerance among the Japanese population. Therefore, we hypothesized that expression of different ALDH2 and ADH2 polymorphisms may induce differences in vascular complications in diabetes and conducted two studies. The first study (study 1) was to determine the association of ALDH2/AHD2 polymorphism with diabetic complications. To know the association of ALDH2/AHD2 polymorphism with diabetic vasculopathy and neuropathy, a total of 158 patients with type 2 diabetes were divided into four groups on the basis of ALDH2 "activity" and ADH2 "superactivity." The frequency of proteinuria and the percentage of proliferative retinopathy among the patients with retinopathy was higher in those with active ALDH2 and superactive ADH2. We speculated that protein kinase C isoforms up-regulated by 4-hydroxynonenal that was detoxified by ALDH2 and ADH2 may account for the long-term development of diabetic nephropathy and severe retinopathy. As for neuropathy, the frequency of symptomatic neuropathy was higher in patients with inactive ALDH2 and usual ADH2. We speculate that increased tissue levels of toxic aldehyde could result from inactive ALDH2 and usual ADH2 expression, which results in the increased level of reactive aldehyde in sensory neuron pathway, thereby causing symptomatic polyneuropathy.  相似文献
5.
糖尿病患者对幽门螺杆菌(Hp)的易感性高于正常人群,且Hp感染可作为糖尿病血管病变的危险因素,但目前对此尚没有统一的结论.Hp感染通过增加急、慢性期反应物和炎性介质、破坏血管内皮细胞、改变血脂水平、氧化状态及凝血状况等机制,参与糖尿病各种血管病变的发生与发展.  相似文献
6.
糖尿病(DM)常并发血管及血栓性疾病,而DM发生血管病变的机制复杂。血栓前状态分子标志物之一的纤溶活性指标——纤溶酶原激活物抑制物-1(PAI-1)在DM及其血管病变的发生发展中起到重要作用。本文拟对DM血管病变与PAI-1关系的研究进展作一综述。  相似文献
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