Mukherjee Amit, Debbarman Tanusree, Banerjee Basu D, Siddiqi Sheelu S
Rajiv Gandhi Centre for Diabetes and Endocrinology, J N Medical College and Hospital, Aligarh Muslim University, Aligarh, Uttar Pradesh, India.
Department of Elementology and Toxicology, Hamdard University, New Delhi, India.
Indian J Endocrinol Metab. 2024 Nov-Dec;28(6):569-578. doi: 10.4103/ijem.ijem_43_24. Epub 2024 Dec 30.
Type 2 diabetes (T2D) is a long-term metabolic condition that presents considerable health challenges globally. As the disease progresses, the interplay between genetic, environmental, and lifestyle factors becomes increasingly evident, leading to complications. Epigenetics has emerged as a critical area of research, providing insights into how these factors can modify the expression and cellular behavior without altering the underlying DNA sequence. Various epigenetic mechanisms, including DNA methylation, histone modifications, chromatin remodeling, and non-coding RNA regulation, drive cell dysfunction, inflammation, and fibrosis, aggravating diabetes and its complications. Amongst all the complications diabetic kidney disease (DKD) also known as diabetic nephropathy (DN), is a significant microvascular complication often regarded as a silent killer, as early diagnosis remains highly complicated. This review investigates various epigenetic modifications associated with T2D and DKD, employing a database search strategy incorporating the PICO framework method to ensure comprehensive coverage of relevant literature. Advancements in epigenome profiling provide valuable insights into the functional outcomes and chromatin states of cells impacted by T2D. Understanding epigenetics thus emphasizes its crucial role in the development and progression of T2D and transition to DKD, while also highlighting the potential reversibility of epigenetic modifications and potency as a biomarker for predicting DKD. More extensive research is needed to identify specific epigenetic mechanisms involved in DKD to further refine predictive models and therapeutic strategies. This unified exploration of significant epigenetic modifications offers a focused analysis of how these alterations influence the trajectory of disease and presents new avenues for therapeutic intervention.
2型糖尿病（T2D）是一种长期的代谢性疾病，在全球范围内带来了相当大的健康挑战。随着疾病的进展，遗传、环境和生活方式因素之间的相互作用变得越来越明显，从而导致并发症。表观遗传学已成为一个关键的研究领域，它为这些因素如何在不改变潜在DNA序列的情况下改变基因表达和细胞行为提供了见解。包括DNA甲基化、组蛋白修饰、染色质重塑和非编码RNA调控在内的各种表观遗传机制会导致细胞功能障碍、炎症和纤维化，加重糖尿病及其并发症。在所有并发症中，糖尿病肾病（DKD）也称为糖尿病性肾病（DN），是一种严重的微血管并发症，常被视为无声杀手，因为早期诊断仍然非常复杂。本综述采用结合PICO框架方法的数据库搜索策略，研究了与T2D和DKD相关的各种表观遗传修饰，以确保全面涵盖相关文献。表观基因组分析的进展为受T2D影响的细胞的功能结果和染色质状态提供了有价值的见解。因此，了解表观遗传学强调了其在T2D的发生和发展以及向DKD转变中的关键作用，同时也突出了表观遗传修饰的潜在可逆性及其作为预测DKD生物标志物的潜力。需要更广泛的研究来确定参与DKD的特定表观遗传机制以进一步完善预测模型和治疗策略。对重要表观遗传修饰的统一探索提供了对这些改变如何影响疾病发展轨迹的重点分析，并为治疗干预提供了新途径。
