Research Division, Joslin Diabetes Center, Boston, MA 02215, USA.
Cell Metab. 2013 Jan 8;17(1):20-33. doi: 10.1016/j.cmet.2012.11.012.
In patients with diabetes, atherosclerosis is the main reason for impaired life expectancy, and diabetic nephropathy and retinopathy are the largest contributors to end-stage renal disease and blindness, respectively. An improved therapeutic approach to combat diabetic vascular complications might include blocking mechanisms of injury as well as promoting protective or regenerating factors, for example by enhancing the action of insulin-regulated genes in endothelial cells, promoting gene programs leading to induction of antioxidant or anti-inflammatory factors, or improving the sensitivity to vascular cell survival factors. Such strategies could help prevent complications despite suboptimal metabolic control.
在糖尿病患者中,动脉粥样硬化是导致预期寿命缩短的主要原因,而糖尿病肾病和视网膜病变分别是导致终末期肾病和失明的最大原因。改善治疗方法以对抗糖尿病血管并发症可能包括阻断损伤机制以及促进保护或再生因子,例如通过增强内皮细胞中胰岛素调节基因的作用、促进导致诱导抗氧化或抗炎因子的基因程序,或改善对血管细胞存活因子的敏感性。即使代谢控制不理想,这些策略也有助于预防并发症。