Zhou Wei, Lee Andy, Zhou Aren, Lombardo Dawn
Division of Cardiology, University of California, Irvine, Orange, CA, United States.
Irvine Valley College, Irvine, CA, United States.
Front Neurosci. 2024 Jan 17;18:1332957. doi: 10.3389/fnins.2024.1332957. eCollection 2024.
The relationship between heart failure and diabetes is intricate and bidirectional. Individuals with diabetes face an elevated risk of developing heart failure due to factors like insulin resistance, chronic inflammation, and metabolic irregularities. Elevated blood sugar levels can harm blood vessels and nerves, culminating in the buildup of fatty deposits in arteries, atherosclerosis, and hypertension, which significantly contribute to heart failure. Furthermore, diabetes can adversely impact the structure and function of the heart muscle, impairing its pumping capacity. Conversely, heart failure can also contribute to the onset of diabetes by disrupting the body's metabolic processes and amplifying insulin resistance. The complex interaction between these conditions mandates a comprehensive approach to managing individuals with both diabetes and heart failure, underscoring the importance of addressing both aspects for enhanced patient outcomes. Although existing pharmacological treatments are limited and frequently associated with undesirable side effects, acupuncture has established itself as a traditional practice with a legacy. It remains a supplementary option for treating cardiovascular diseases. Heart failure and diabetes are both heavily associated with chronic upregulation of the sympathetic nervous system, which has been identified as a pivotal factor in the progression of disease. Mechanistic interplays such as the attenuation of central nitric oxide signaling may interfere with the production or availability of nitric oxide in key areas of the central nervous system, including the brainstem and hypothalamus. This review will delve into the current understanding of acupuncture on the autonomic nervous system and offer insights into its potential role in the future treatment landscape for diabetes and heart failure.
心力衰竭与糖尿病之间的关系错综复杂且呈双向性。糖尿病患者由于胰岛素抵抗、慢性炎症和代谢紊乱等因素，发生心力衰竭的风险升高。血糖水平升高会损害血管和神经，最终导致动脉中脂肪沉积物的积累、动脉粥样硬化和高血压，这些都会显著促成心力衰竭。此外，糖尿病会对心肌的结构和功能产生不利影响，损害其泵血能力。相反，心力衰竭也会通过扰乱身体的代谢过程和加剧胰岛素抵抗而促使糖尿病的发生。这些病症之间的复杂相互作用要求对同时患有糖尿病和心力衰竭的患者采取综合管理方法，凸显了兼顾两个方面以改善患者预后的重要性。尽管现有的药物治疗有限且常常伴有不良副作用，但针灸作为一种有着悠久历史的传统疗法已确立了自身地位。它仍然是治疗心血管疾病的一种辅助选择。心力衰竭和糖尿病都与交感神经系统的慢性上调密切相关，交感神经系统已被确定为疾病进展的关键因素。诸如中枢一氧化氮信号减弱等机制性相互作用可能会干扰中枢神经系统关键区域（包括脑干和下丘脑）一氧化氮的产生或可用性。本综述将深入探讨目前对针灸作用于自主神经系统的理解，并对其在糖尿病和心力衰竭未来治疗前景中的潜在作用提供见解。
