U.O.C. Clinica Medica e Malattie Vascolari, Catholic University School of Medicine, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo Francesco Vito, 1, 00168, Rome, Italy.
Laboratory of Vascular Biology and Genetics, Università Cattolica del Sacro Cuore, Rome, Italy.
Intern Emerg Med. 2020 Apr;15(3):381-393. doi: 10.1007/s11739-019-02270-6. Epub 2020 Jan 9.
Experimental and clinical studies aimed at investigating the mechanism(s) underlying vascular complications of diabetes indicate that a great number of molecules are involved in the pathogenesis of these complications. Most of these molecules are inflammatory mediators or markers generated by immune or adipose tissue. Some of them, i.e. resistin and sortilin, have been shown to be involved in the cross talk between adipocytes and inflammatory cells. This interaction is an attractive area of research, particularly in type 2 diabetes and obesity. Other proteins, such as adiponectin and visfatin, appear to be more promising as possible vascular markers. In addition, some molecules involved in calcium/phosphorus metabolism, such as klotho and FGF23, have an involvement in the pathogenesis of diabetic vasculopathy, which appears to be dependent on the degree of vascular impairment. Inflammatory markers are a promising tool for treatment decisions while measuring plasma levels of adipokines, sortilin, Klotho and FGF23 in adequately sized longitudinal studies is expected to allow a more precise characterization of diabetic vascular disease and the optimal use of personalized treatment strategies.
实验和临床研究旨在探讨糖尿病血管并发症的发病机制，表明许多分子参与了这些并发症的发生。这些分子大多是由免疫或脂肪组织产生的炎症介质或标志物。其中一些，如抵抗素和分选素，已被证明参与了脂肪细胞和炎症细胞之间的信号传递。这种相互作用是一个很有吸引力的研究领域，特别是在 2 型糖尿病和肥胖症中。其他一些蛋白质，如脂联素和内脂素，似乎更有希望成为潜在的血管标志物。此外，一些参与钙/磷代谢的分子，如 klotho 和 FGF23，也参与了糖尿病血管病变的发病机制，这似乎依赖于血管损伤的程度。炎症标志物是治疗决策的有前途的工具，而在足够大的纵向研究中测量血浆脂联素、分选素、klotho 和 FGF23 的水平，有望更精确地描述糖尿病血管疾病，并优化个性化治疗策略的应用。
