Liu Dorothy, Baqar Sara, Lincz Lisa L, Ekinci Elif I
Department of Medicine, Austin Health, Heidelberg, Victoria, Australia.
Department of Medicine, The University of Melbourne, Melbourne, Australia.
Curr Diabetes Rev. 2019;15(6):435-445. doi: 10.2174/1573399815666190212120822.
There is ongoing debate surrounding the complex relationship between dietary sodium intake and cardiovascular morbidity and mortality. The existing literature consists largely of observational studies that have demonstrated positive, negative, U-/J-shaped or unclear associations between sodium intake and cardiovascular outcomes. Our group and others have previously demonstrated an inverse relationship between dietary sodium intake and cardiovascular outcomes in people with type 2 diabetes. Increased activity of the renin-angiotensin-aldosterone system and sympathetic nervous system is postulated to contribute to these paradoxical findings through endothelial dysfunction, a precursor to the development of cardiovascular disease. Microvesicles are submicron (0.1 - 1.0μm) vesicles that form during cellular activation, injury or death with endothelial microvesicles being recognized markers of endothelial dysfunction. They are pathologically elevated in a variety of vascular-related conditions including type 2 diabetes. Lower habitual sodium intake in type 2 diabetes has been associated with higher pro-coagulant platelet microvesicles levels but not with endothelial microvesicles. Research utilizing endothelial microvesicles to evaluate the mechanistic relationship between dietary sodium intake and adverse cardiovascular outcomes in type 2 diabetes remains scarce.
关于饮食中钠摄入量与心血管疾病发病率和死亡率之间的复杂关系，目前仍存在争议。现有文献主要由观察性研究组成，这些研究表明钠摄入量与心血管结局之间存在正相关、负相关、U形/ J形或不明确的关联。我们小组和其他研究团队之前已经证明，2型糖尿病患者的饮食钠摄入量与心血管结局呈负相关。肾素 - 血管紧张素 - 醛固酮系统和交感神经系统活性增加，被认为是通过内皮功能障碍导致这些矛盾结果的原因，而内皮功能障碍是心血管疾病发展的先兆。微泡是在细胞激活、损伤或死亡过程中形成的亚微米（0.1 - 1.0μm）大小的囊泡，内皮微泡是内皮功能障碍的公认标志物。在包括2型糖尿病在内的多种血管相关疾病中，它们在病理上会升高。2型糖尿病患者较低的习惯性钠摄入量与较高的促凝血血小板微泡水平有关，但与内皮微泡无关。利用内皮微泡评估2型糖尿病患者饮食钠摄入量与不良心血管结局之间的机制关系的研究仍然很少。
