Halushka P V, Mayfield R, Colwell J A
Metabolism. 1985 Dec;34(12 Suppl 1):32-6. doi: 10.1016/s0026-0495(85)80007-x.
The alterations in the metabolism of arachidonic acid to prostaglandin I2 (prostacyclin), a vasodilator antiaggregatory substance, and thromboxane A2, a vasoconstrictor proaggregatory substance, in diabetes mellitus are reviewed in this article. When tested in vitro, platelet aggregation is enhanced in some patients with diabetes mellitus. The synthesis of thromboxane B2, the stable metabolite of thromboxane A2, by platelets is increased in patients with diabetes mellitus compared with control subjects. This increased synthesis appears to play a role in the enhanced platelet aggregation since the latter can be reversed by aspirin treatment and in vitro by the thromboxane receptor-antagonist 13-azaprostanoic acid. Vascular prostacyclin synthesis is decreased in both patients and experimental animals with diabetes mellitus. Treatment of experimental animals with insulin reverses the decreased synthesis of prostacyclin. The etiology of the altered arachidonic acid metabolism remains uncertain but appears to be multifactorial and includes alterations in metabolic control and circulating immune complexes. The increased ratio of thromboxane A2 to prostacyclin, which favors an enhanced thrombotic state, may play a role in the accelerated vascular disease of diabetes mellitus.
本文综述了糖尿病患者中花生四烯酸代谢为前列腺素I2（前列环素，一种血管舒张和抗聚集物质）和血栓素A2（一种血管收缩和促聚集物质）的变化。在体外试验时，一些糖尿病患者的血小板聚集增强。与对照组相比，糖尿病患者血小板合成血栓素A2的稳定代谢产物血栓素B2增加。这种合成增加似乎在增强的血小板聚集中起作用，因为后者可通过阿司匹林治疗以及在体外通过血栓素受体拮抗剂13-氮杂前列腺烷酸逆转。糖尿病患者和实验动物的血管前列环素合成均减少。用胰岛素治疗实验动物可逆转前列环素合成的减少。花生四烯酸代谢改变的病因仍不确定，但似乎是多因素的，包括代谢控制的改变和循环免疫复合物。血栓素A2与前列环素的比例增加有利于增强血栓形成状态，可能在糖尿病加速的血管疾病中起作用。
