[1]张 静,李 刚.糖尿病心肌病病理机制研究[J].医学信息,2020,33(02):43-46.[doi:10.3969/j.issn.1006-1959.2020.02.012]
 ZHANG Jing,LI Gang.Research on Pathological Mechanism of Diabetic Cardiomyopathy[J].Medical Information,2020,33(02):43-46.[doi:10.3969/j.issn.1006-1959.2020.02.012]
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糖尿病心肌病病理机制研究()

医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
33卷
期数:
2020年02期
页码:
43-46
栏目:
综述
出版日期:
2020-01-15

文章信息/Info

Title:
Research on Pathological Mechanism of Diabetic Cardiomyopathy
文章编号:
1006-1959(2020)02-0043-04
作者:
张 静李 刚
(重庆医科大学附属第一医院老年病科,重庆 400016)
Author(s):
ZHANG Jing1LI Gang2
(Department of Geriatrics,the First Affiliated Hospital of Chongqing Medical University,Chongqing 400016,China)
关键词:
糖尿病糖尿病心肌病结构改变病理机制
Keywords:
DiabetesDiabetic cardiomyopathyStructural changesPathological mechanism
分类号:
R587.2
DOI:
10.3969/j.issn.1006-1959.2020.02.012
文献标志码:
A
摘要:
糖尿病心肌病(DCM)是糖尿病严重并发症之一,包括DCM在内的心血管并发症占糖尿病死亡的80%以上。了解其病理机制对预防和治疗DCM至关重要。目前已有大量的研究表明,DCM具有高血糖、胰岛素抵抗、底物代谢异常、晚期糖基化终末产物蓄积、PKC及PPAR信号激活、氧化应激、钙稳态障碍、线粒体功能障碍等病理生理机制。本文主要就DCM发生和进展中所涉及的病理生理机制以及结构改变作一综述。
Abstract:
Diabetic cardiomyopathy (DCM) is one of the serious complications of diabetes,and cardiovascular complications including DCM account for more than 80% of diabetes deaths.Understanding its pathogenesis is critical to prevent and treat DCM.A large number of studies have shown that DCM has pathologies such as hyperglycemia,insulin resistance,abnormal substrate metabolism,accumulation of advanced glycation end products, PKC and PPAR signal activation,oxidative stress, calcium homeostasis,and mitochondrial dysfunction Physiological mechanism.This article reviews the pathophysiological mechanisms and structural changes involved in the occurrence and progression of DCM.

参考文献/References:

[1]Cho NH,Shaw JE,Karuranga S,et al.IDF Diabetes Atlas:Global estimates of diabetes prevalence for 2017 and projections for 2045[J].Diabetes Res Clin Pract,2018(138):271-281. [2]Collaboration NCDRF.Worldwide trends in diabetes since 1980:a pooled analysis of 751 population-basedstudies with 4.4 million participants[J].Lancet,387(10027):1513-1530. [3]Alonso N,Moliner P,Mauricio D.Pathogenesis,Clinical Features and Treatment of Diabetic Cardiomyopathy[J].Adv Exp Med Biol,2018(1067):197-217. [4]Gilca GE,Stefanescu G,Badulescu O,et al.Diabetic Cardiomyopathy:Current Approach and Potential Diagnostic and Therapeutic Targets[J].J Diabetes Res,2017(2017):1310265. [5]Carpentier AC.Abnormal Myocardial Dietary Fatty Acid Metabolism and Diabetic Cardiomyopathy[J].Can J Cardiol,2018,34(5):605-614. [6]Mansor LS,Mehta K,Aksentijevic D,et al.Increased oxidative metabolism following hypoxia in the type 2 diabetic heart,despite normal hypoxia signalling and metabolic adaptation[J].J Physiol,2016,594(2):307-320. [7]Nakanishi T,Kato S.Impact of diabetes mellitus on myocardial lipid deposition:an autopsy study[J].Pathol Res Pract,2014,210(12):1018-1025. [8]Dey D,Basu D,Roy SS,et al.Involvement of novel PKC isoforms in FFA induced defects in insulin signaling[J].Molecular and Cellular Endocrinology,2006,246(1-2):60-64. [9]Bodiga VL,Eda SR,Bodiga S.Advanced glycation end products:role in pathology of diabetic cardiomyopathy[J].Heart Fail Rev,2014,19(1):49-63. [10]Deluyker D,Evens L,Bito V.Advanced glycation end products(AGEs)and cardiovascular dysfunction:focus on high molecular weight AGEs[J].Amino Acids,2017,49(9):1535-1541. [11]Li Z,Abdullah CS,Jin ZQ.Inhibition of PKC-theta preserves cardiac function and reduces fibrosis in streptozotocin-induced diabetic cardiomyopathy[J].Br J Pharmacol,2014,171(11):2913-2924. [12]Zakaria EM,El-Bassossy HM,El-Maraghy NN,et al.PARP-1 inhibition alleviates diabetic cardiac complications in experimental animals[J].Eur J Pharmacol,2016(791):444-454. [13]Al-Jiffri OH,Al-Sharif FM,Al-Jiffri EH,et al.Intrinsic disorder in biomarkers of insulin resistance,hypoadiponectinemia,and endothelial dysfunction among the type 2 diabetic patients[J].Intrinsically Disord Proteins,2016,4(1):e1171278. [14]Li S,Hong Y,Jin X,et al.A new Agkistrodon halys venom-purified protein C activator prevents myocardial fibrosis in diabetic rats[J].Croat Med J,2015,56(5):439-446. [15]符显昭,冯雪萍,丘海先,等.降糖舒心方对糖尿病心肌细胞内质网应激Caspase-12凋亡旁路及心功能的影响[J].中华中医药学刊,2019(9):2423-2427. [16]Wagner S,Rokita AG,Anderson ME,et al.Redox regulation of sodium and calcium handling[J].Antioxid Redox Signal,2013,8(9):1063-1077. [17]薛瑞凤,孙冬梅,郭淑香,等.大鼠糖尿病性心肌病的超声心动图研究[J].中华超声影像学杂志,2008,17(10):903-907. [18]Singh RM,Waqar T,Howarth FC,et al.Hyperglycemia-induced cardiac contractile dysfunction in the diabetic heart[J].Heart Fail Rev,2018,23(1):37-54. [19]Zhang GX,Obata K,Takeshita D,et al.Evaluation of left ventricular mechanical work and energetics of normal hearts in SERCA2a transgenic rats[J].J Physiol Sci,2012,62(3):221-231. [20]Roger VL,Go AS,Lloyd-Jones DM,et al.Executive summary:heart disease and stroke statistics-2012 update:a report from the American Heart Association[J].Circulation,2012,125(1):188-197. [21]Ward ML,Crossman DJ.Mechanisms underlying the impaired contractility of diabetic cardiomyopathy[J].World J Cardiol,2014,6(7):577-584. [22]Joseph JJ,Echouffo Tcheugui JB,Effoe VS,et al.Renin-Angiotensin-Aldosterone System,Glucose Metabolism and Incident Type 2 Diabetes Mellitus:MESA[J].J Am Heart Assoc,2018,7(17):e009890. [23]Rosin NL,Falkenham A,Sopel MJ,et al.Regulation and role of connective tissue growth factor in AngII-induced myocardial fibrosis[J].Am J Pathol,2013,182(3):714-726. [24]Thomas CM,Yong QC,Seqqat R,et al.Direct renin inhibition prevents cardiac dysfunction in a diabetic mouse model:comparison with an angiotensin receptor antagonist and angiotensin-converting enzyme inhibitor[J].Clin Sci(Lond),2013,124(8):529-541. [25]肖凤英.糖尿病心肌病与早期扩张性心肌病心肌线粒体通透性转运孔开放的对比观察[J].中国中医药咨讯,2011,3(20):14-15. [26]Joshi M,Kotha SR,Malireddy S,et al.Conundrum of pathogenesis of diabetic cardiomyopathy: role of vascular endothelial dysfunction,reactive oxygen species,and mitochondria[J].Mol Cell Biochem,2014,386(1-2):233-249. [27]Ansari M,Kurian GA.Hydrogen sulfide preconditioning could ameliorate reperfusion associated injury in diabetic cardiomyopathy rat heart through preservation of mitochondria[J].Biochimie,2019(158):208-216. [28]Mejia EM,Hatch GM.Mitochondrial phospholipids:role in mitochondrial function[J].J Bioenerg Biomembr,2016,48(2):99-112. [29]Pepin ME,Wende AR.Epigenetics in the development of diabetic cardiomyopathy[J].Epigenomics,2019,11(5):469-472. [30]Jia G,Whaley-Connell A,Sowers JR.Diabetic cardiomyopathy:a hyperglycaemia-and insulin-resistance-induced heart disease[J].Diabetologia,2018,61(1):21-28. [31]Miki T,Yuda S,Kouzu H,et al.Diabetic cardiomyopathy:pathophysiology and clinical features[J].Heart Fail Rev,2013,18(2):149-166. [32]Adeghate E,Singh J.Structural changes in the myocardium during diabetes-induced cardiomyopathy[J].Heart Fail Rev,2014,19(1):15-23. [33]Parim B,Sathibabu Uddandrao VV,Saravanan G.Diabetic cardiomyopathy:molecular mechanisms, detrimental effects of conventional treatment,and beneficial effects of natural therapy[J].Heart Fail Rev,2019,24(2):279-299. [34]Pappachan JM,Varughese GI,Sriraman R,et al.Diabetic cardiomyopathy:Pathophysiology,diagnostic evaluation and management[J].World J Diabetes,2013,4(5):177-189. [35]Marwick TH,Ritchie R,Shaw JE,et al.Implications of Underlying Mechanisms for the Recognition and Management of Diabetic Cardiomyopathy[J].J Am Coll Cardiol,2018,71(3):339-351. [36]Lehrke M,Marx N.Diabetes Mellitus and Heart Failure[J].Am J Med,2017,130(6S):S40-S50.

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更新日期/Last Update: 2020-01-15