Legiawati Lili
Department of Dermatology and Venereology, Faculty of Medicine, Universitas Indonesia - dr. Cipto Mangunkusumo National General Hospital Jakarta, Jakarta 10430, Indonesia.
Curr Diabetes Rev. 2022;18(3):e200921196637. doi: 10.2174/1573399817666210920102318.
Diabetes mellitus is a metabolic disorder caused by an increase in insulin resistance, a decrease in insulin production, or both of them, resulting in a high level of blood glucose or hyperglycemia. An uncontrolled state of DM may cause complications, namely skin disorder. One or more skin disorders are found amongst 74% of T2DM patients, with the highest percentage is dry skin (47%), followed by infection (10%), diabetic hand (5%), hair loss and diabetic dermopathy (each 4%). In DM, the state of hyperglycemia and production of advanced glycaemic end-products (AGEs) profoundly impact skin changes. In the pathological pathway, AGEs induce oxidative stress and inflammation. Nonetheless, AGEs level is higher in T2DM patients compared to non- T2DM people. This is caused by hyperglycemia and oxidative stress. Binding between AGEs and receptor of AGEs (RAGE) promotes pathway of oxidative stress and inflammation cascade via mitogen- activated protein kinases (MAPK), nuclear factor-k-light-chain-enhancer of activated β cells (NF-kβ), interleukin- 6 (IL-6), tumor necrosis factor-α (TNF-α), expression of intercellular adhesion molecule 1 (ICAM-1) and vascular cell adhesion molecule 2 (VCAM-2) pathway which furtherly effectuates DM complication including skin disorders.
糖尿病是一种代谢紊乱疾病，由胰岛素抵抗增加、胰岛素分泌减少或两者兼而有之引起，导致血糖水平升高或高血糖。糖尿病的失控状态可能会引发并发症，即皮肤疾病。在2型糖尿病患者中，74%的患者存在一种或多种皮肤疾病，其中比例最高的是皮肤干燥（47%），其次是感染（10%）、糖尿病手部病变（5%）、脱发和糖尿病性皮肤病（各占4%）。在糖尿病中，高血糖状态和晚期糖基化终产物（AGEs）的产生对皮肤变化有深远影响。在病理途径中，AGEs会诱导氧化应激和炎症。尽管如此，与非2型糖尿病患者相比，2型糖尿病患者体内的AGEs水平更高。这是由高血糖和氧化应激引起的。AGEs与AGEs受体（RAGE）之间的结合通过丝裂原活化蛋白激酶（MAPK）、活化β细胞的核因子-κ轻链增强子（NF-κβ）、白细胞介素-6（IL-6）、肿瘤坏死因子-α（TNF-α）、细胞间黏附分子1（ICAM-1）和血管细胞黏附分子2（VCAM-2）途径促进氧化应激和炎症级联反应，进而导致包括皮肤疾病在内的糖尿病并发症。
