除了糖尿病之外的微血管疾病:一种代谢连续体,对早期检测和糖尿病护理有影响
Xiaohan Xu1, Shanhu Qiu2, Tongzhi Wu3
1Department of Endocrinology, Zhongda Hospital, Institute of Diabetes, School of Medicine, Southeast University, Nanjing, China; Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, United Kingdom.
微血管疾病,通常与糖尿病有关,也由更广泛的代谢功能障碍引起. 除了葡萄糖之外的管理因素是预防血管并发症的关键.
科学领域:
- 内分泌学 在内分泌学.
- 血管生物学 血管生物学
- 代谢综合征是代谢综合征的一种.
背景情况:
- 微血管疾病 (视网膜病变,病变,神经病变) 是一种主要的糖尿病并发症,传统上与慢性高血糖症有关.
- 现有的仅关注葡萄糖的模型可能无法完全解释微血管损伤,因为它发生在非糖尿病患者中,并且仅仅通过降低葡萄糖而无法消除.
研究的目的:
- 提出代谢微血管疾病 (MMD) 的概念,将微血管病理重新定义为代谢失调的系统后果.
- 在糖尿病和非糖尿病人群中综合MMD的证据,概述病原机制和临床识别框架.
主要方法:
- 对流行病学研究和临床试验的审查.
- 关于微血管疾病的共同和独特的致病机制的证据综合.
- 开发一种代谢微血管疾病的概念框架.
主要成果:
- 微血管异常在代谢功能障碍的连续性中普遍存在,先于明显的高血糖症.
- 非血糖因素 (高血压,脂质失调,胰岛素抵抗,炎症) 显著导致微血管损伤.
- 代谢障碍预示着较早的血管脆弱性,影响糖尿病前期和代谢功能障碍的早期阶段.
结论:
- 代谢性微血管疾病 (MMD) 提供了一个比糖尿病特异性并发症更广泛的视角.
- 早期识别和MMD风险分层对于临床实践至关重要.
- 预防策略必须超越降低葡萄糖,扩展到全面的代谢风险管理.
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