Kubisz Peter, Stančiaková Lucia, Staško Ján, Galajda Peter, Mokáň Marián
Peter Kubisz, Lucia Stančiaková, Ján Staško, National Centre of Haemostasis and Thrombosis, Clinic of Haematology and Transfusiology, Comenius University in Bratislava, Jessenius Faculty of Medicine and University Hospital in Martin, 03659 Martin, Slovak Republic.
World J Diabetes. 2015 Apr 15;6(3):423-31. doi: 10.4239/wjd.v6.i3.423.
Diabetes mellitus (DM) is an extremely common disorder which carries a risk of vascular impairment. DM type 2 (DM2) can be characterized by the dysfunction of haemostasis manifesting by stimulated coagulation process, disorder of platelet function and decreased fibrinolytic activity. These all are the reasons why DM2 is the most common acquired thrombophilia. Endothelial dysfunction along with platelet hyperactivity are unquestionably involved in the hyperactivation of platelets and clotting factors in DM. As a natural consequence of continuous investigation, many markers of endothelial dysfunction and diabetic thrombocytopathy have been identified and considered for implementation in clinical practice. Endothelial function can be assessed by the evaluation of endothelial markers, circulating molecules synthesised in various amounts by the endothelium. These markers precede the signs of evident microangiopathy. Platelets have an ethiopathogenic relation to the microangiopathy in DM. Their increased activity was confirmed in both types of DM. Predictors of endothelial and platelet disorder could improve the screening of individuals at increased risk, thus leading to the early diagnosis, appropriate treatment, as well as to the effective prevention of the complications of DM2. In the article we deal with the mechanisms involved in the pathogenesis of endothelial and platelet functional abnormalities, endothelial and platelet markers of DM2 considered for implementation in clinical practice and possibilities of their detection.
糖尿病(DM)是一种极为常见的疾病,存在血管受损风险。2型糖尿病(DM2)的特征在于止血功能障碍,表现为凝血过程受刺激、血小板功能紊乱以及纤溶活性降低。这些都是DM2成为最常见后天性易栓症的原因。内皮功能障碍以及血小板活性亢进无疑与DM中血小板和凝血因子过度活化有关。随着持续研究的自然结果,许多内皮功能障碍和糖尿病性血小板病的标志物已被识别,并被考虑应用于临床实践。内皮功能可通过评估内皮标志物来进行评估,内皮标志物是由内皮细胞合成的各种数量的循环分子。这些标志物先于明显微血管病变的体征出现。血小板与DM中的微血管病变存在病因学关系。在两种类型的糖尿病中均证实其活性增加。内皮和血小板紊乱的预测指标可改善对高危个体的筛查,从而实现早期诊断、恰当治疗以及有效预防DM2的并发症。在本文中,我们探讨了内皮和血小板功能异常发病机制中涉及的机制、考虑应用于临床实践的DM2内皮和血小板标志物及其检测可能性。