Department of Neurology, University of Michigan, Ann Arbor, Michigan, USA.
Curr Opin Endocrinol Diabetes Obes. 2020 Apr;27(2):115-123. doi: 10.1097/MED.0000000000000533.
To summarize recent advancements in our understanding of the impact of dyslipidemia on microvascular complications in type 2 diabetes (T2D), with an emphasis on peripheral neuropathy and nephropathy.
Mounting evidence suggests that rigorous glycemic control only mitigates certain microvascular complications in T2D patients. Particularly, well regulated blood glucose levels only marginally improve peripheral neuropathy in the T2D setting. Dyslipidemia, an abnormal lipid profile, is emerging as a key factor in peripheral neuropathy. Furthermore, although glycemic control may prevent or slow nephropathy, recent developments demonstrate that dyslipidemia can also affect kidney outcomes in normoglycemic patients. Transcriptomic, epigenomic, and lipidomic investigations, as well as integrative approaches, are shedding light on potential pathomechanisms. These molecular studies are identifying possible targets for therapeutic intervention. Complementing molecular research, lifestyle interventions are on-going to assess whether dietary choices and/or exercise, weight-loss, or surgical interventions, such as bariatric surgery, can ameliorate peripheral neuropathy and nephropathy in T2D patients.
Dyslipidemia is an emerging mechanism in microvascular complications in T2D. Elucidating the molecular pathomechanisms may pinpoint potential lipid-centric treatments. Interventional studies of dietary changes, exercise, or weight-loss surgery may also positively impact these highly prevalent and morbid complications.
总结血脂异常对 2 型糖尿病（T2D）微血管并发症影响的最新进展，重点关注周围神经病变和肾病。
越来越多的证据表明，严格的血糖控制只能减轻 T2D 患者的某些微血管并发症。特别是，血糖控制良好仅能轻微改善 T2D 患者的周围神经病变。血脂异常，即异常的脂质谱，正成为周围神经病变的一个关键因素。此外，尽管血糖控制可能预防或延缓肾病，但最近的研究表明，血脂异常也会影响血糖正常的患者的肾脏结局。转录组学、表观基因组学和脂质组学研究以及综合方法正在揭示潜在的病理机制。这些分子研究正在确定可能的治疗干预靶点。补充分子研究，生活方式干预正在评估饮食选择和/或运动、减肥或手术干预（如减肥手术）是否可以改善 T2D 患者的周围神经病变和肾病。
血脂异常是 T2D 微血管并发症的一个新出现的机制。阐明分子病理机制可能会指出潜在的以脂质为中心的治疗方法。饮食改变、运动或减肥手术的干预研究也可能对这些高度流行和病态的并发症产生积极影响。
