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未来糖尿病的检测和监测可能需要分析β细胞功能和体积:β细胞丢失的标志物如何提供帮助。

Future detection and monitoring of diabetes may entail analysis of both β-cell function and volume: how markers of β-cell loss may assist.

机构信息

Nordic Bioscience A/S, Herlev Hovedgade 207, DK-2730, Herlev, Denmark.

出版信息

J Transl Med. 2012 Oct 30;10:214. doi: 10.1186/1479-5876-10-214.

Abstract

Disease heterogeneity is as major issue in Type II Diabetes Mellitus (T2DM), and this patient inter-variability might not be sufficiently reflected by measurements of glycated haemoglobin (HbA1c).Β-cell dysfunction and β-cell death are initiating factors in development of T2DM. In fact, β-cells are known vanish prior to the development of T2DM, and autopsy of overt T2DM patients have shown a 60% reduction in β-cell mass.As the decline in β-cell function and mass have been proven to be pathological traits in T2DM, methods for evaluating β-cell loss is becoming of more interest. However, evaluation of β-cell death or loss is currently invasive and unattainable for the vast majority of diabetes patients. Serological markers, reflecting β-cell loss would be advantageous to detect and monitor progression of T2DM. Biomarkers with such capacities could be neo-epitopes of proteins with high β-cell specificity containing post translational modifications. Such tools may segregate T2DM patients into more appropriate treatment groups, based on their β-cell status, which is currently not possible. Presently individuals presenting with adequately elevated levels of both insulin and glucose are classified as T2DM patients, while an important subdivision of those is pending, namely those patients with sufficient β-cell capacity and those without. This may warrant two very different treatment options and patient care paths.Serological biomarkers reflecting β-cell health status may also assist development of new drugs for T2DM and aid physicians in better characterization of individual patients and tailor individual treatments and patient care protocols.

摘要

疾病异质性是 2 型糖尿病(T2DM)的一个主要问题,而糖化血红蛋白(HbA1c)的测量可能无法充分反映患者的这种个体差异。β细胞功能障碍和β细胞死亡是 T2DM 发展的起始因素。事实上,β细胞在 T2DM 发生之前就已经消失,尸检显示明显的 T2DM 患者的β细胞数量减少了 60%。由于β细胞功能和数量的下降已被证明是 T2DM 的病理特征,因此评估β细胞损失的方法变得越来越重要。然而,评估β细胞死亡或损失目前是侵入性的,对于绝大多数糖尿病患者来说是无法实现的。反映β细胞损失的血清标志物将有利于检测和监测 T2DM 的进展。具有这种能力的生物标志物可以是具有高β细胞特异性的蛋白质的新表位,包含翻译后修饰。这些工具可以根据β细胞状态将 T2DM 患者分为更合适的治疗组,而目前这是不可能的。目前,胰岛素和葡萄糖水平均升高的个体被归类为 T2DM 患者,而其中一个重要的亚组尚未确定,即那些具有足够β细胞能力的患者和那些没有的患者。这可能需要两种非常不同的治疗选择和患者护理路径。反映β细胞健康状况的血清生物标志物也可能有助于开发治疗 T2DM 的新药,并帮助医生更好地对个体患者进行特征描述,制定个体化的治疗和患者护理方案。

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