Huo Jin-Ling, Feng Qi, Pan Shaokang, Fu Wen-Jia, Liu Zhangsuo, Liu Zhenzhen
Traditional Chinese Medicine Integrated Department of Nephrology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, P. R. China.
Research Institute of Nephrology, Zhengzhou University, Zhengzhou, 450052, P. R. China.
Cell Death Discov. 2023 Jul 21;9(1):256. doi: 10.1038/s41420-023-01553-4.
Diabetic cardiomyopathy (DCM) mainly refers to myocardial metabolic dysfunction caused by high glucose, and hyperglycemia is an independent risk factor for cardiac function in the absence of coronary atherosclerosis and hypertension. DCM, which is a severe complication of diabetes, has become the leading cause of heart failure in diabetic patients. The initial symptoms are inconspicuous, and patients gradually exhibit left ventricular dysfunction and eventually develop total heart failure, which brings a great challenge to the early diagnosis of DCM. To date, the underlying pathological mechanisms of DCM are complicated and have not been fully elucidated. Although there are therapeutic strategies available for DCM, the treatment is mainly focused on controlling blood glucose and blood lipids, and there is a lack of effective drugs targeting myocardial injury. Thus, a large percentage of patients with DCM inevitably develop heart failure. Given the neglected initial symptoms, the intricate cellular and molecular mechanisms, and the lack of available drugs, it is necessary to explore early diagnostic biomarkers, further understand the signaling pathways involved in the pathogenesis of DCM, summarize the current therapeutic strategies, and develop new targeted interventions.
糖尿病性心肌病（DCM）主要指由高血糖引起的心肌代谢功能障碍，并且在没有冠状动脉粥样硬化和高血压的情况下，高血糖是心脏功能的独立危险因素。DCM作为糖尿病的一种严重并发症，已成为糖尿病患者心力衰竭的主要原因。其初始症状不明显，患者逐渐出现左心室功能障碍并最终发展为全心衰竭，这给DCM的早期诊断带来了巨大挑战。迄今为止，DCM的潜在病理机制复杂，尚未完全阐明。虽然有针对DCM的治疗策略，但治疗主要集中在控制血糖和血脂，缺乏针对心肌损伤的有效药物。因此，很大一部分DCM患者不可避免地会发展为心力衰竭。鉴于初始症状被忽视、细胞和分子机制错综复杂以及缺乏可用药物，有必要探索早期诊断生物标志物，进一步了解参与DCM发病机制的信号通路，总结当前的治疗策略，并开发新的靶向干预措施。
