Candido Riccardo, Zanetti Michela
Diabetology Center, Azienda per i Servizi Sanitari n. 1 Triestina, Italy.
Ital Heart J. 2005 Sep;6(9):703-20.
Cardiovascular complications are the leading cause of death in diabetes. Over the past decade a number of studies have addressed the underlying mechanisms. Derangements of endothelial function, also referred to as endothelial dysfunction, have emerged to be the crucial early step in the development of atherosclerosis and are also involved in plaque progression and clinical emergence. Endothelial dysfunction is a condition of impaired endothelium-dependent vasodilation and most important of "endothelial activation", characterized by a proinflammatory, proliferative, and procoagulatory milieu that promotes initiation and complications of atherogenesis. A synergistic cross-talk among the conventional cardiovascular risk factors associated with diabetes contributes to disruption of endothelial integrity and accelerated atherosclerosis. This review will focus on the multifactorial nature of endothelial dysfunction in diabetes, the relationship between endothelial dysfunction, conventional cardiovascular risk factors and atherosclerosis, and the therapeutic options to improve endothelial function.
心血管并发症是糖尿病患者死亡的主要原因。在过去十年中，多项研究探讨了其潜在机制。内皮功能紊乱，也称为内皮功能障碍，已成为动脉粥样硬化发生发展的关键早期步骤，并且还参与斑块进展和临床发病。内皮功能障碍是一种内皮依赖性血管舒张受损的状态，也是“内皮激活”的最重要表现，其特征是促炎、增殖和促凝环境，促进动脉粥样硬化的起始和并发症。与糖尿病相关的传统心血管危险因素之间的协同相互作用导致内皮完整性破坏和动脉粥样硬化加速。本综述将重点关注糖尿病内皮功能障碍的多因素性质、内皮功能障碍、传统心血管危险因素与动脉粥样硬化之间的关系，以及改善内皮功能的治疗选择。
