Srikanthan Preethi, Hsueh Willa
University of California at Los Angeles, Los Angeles, CA 90095-7073, USA.
Med Clin North Am. 2004 Sep;88(5):1237-56. doi: 10.1016/j.mcna.2004.05.004.
Diabetic cardiomyopathy is characterized by a prominent interstitial fibrosis. Postulated etiologies include microangiopathy, autonomic neuropathy, and metabolic factors. A common root of these pathologies is hyperglycemia or hyperinsulinemia, both of which are prominent in type 2 diabetes mellitus, which has the highest incidence of cardiovascular morbidity and mortality. The relative importance of each factor is a matter of debate; it is likely that both of these factors in addition to the concomitant risk factors seen in diabetics (dyslipidemias, hypertension, obesity, coagulation abnormalities) contribute to the spectrum of myocardial disease in diabetes. A discussion of these contributive pathologies and the hyperglycemia and hyperinsulinemia that underlie them is the subject of this review. Treatment methodologies to control the development of such pathology also are discussed.
糖尿病性心肌病的特征是显著的间质纤维化。推测的病因包括微血管病变、自主神经病变和代谢因素。这些病理状况的一个共同根源是高血糖或高胰岛素血症，这两者在2型糖尿病中都很突出，而2型糖尿病的心血管发病率和死亡率最高。每个因素的相对重要性存在争议；除了糖尿病患者常见的伴随危险因素（血脂异常、高血压、肥胖、凝血异常）外，这两个因素可能都对糖尿病心肌疾病谱有影响。本文综述的主题是讨论这些促成病理状况以及作为其基础的高血糖和高胰岛素血症。还讨论了控制此类病理状况发展的治疗方法。
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