Abrass C K
Department of Medicine, University of Washington School of Medicine, Seattle, USA.
West J Med. 1995 Apr;162(4):318-21.
Diabetic nephropathy, a major cause of morbidity and mortality in patients with diabetes mellitus, is characterized by the progressive expansion of mesangial matrix that ultimately occludes glomerular capillaries. Multiple factors in the abnormal metabolic milieu of diabetes contribute to the development of increased amounts of mesangial matrix. Glucose stimulates an increase in synthesis of most collagens and matrix glycoproteins normally expressed within the mesangium. Abnormal glycosylation of matrix proteins interferes with their degradation and turnover. Periods of hyperinsulinemia and alterations in angiotensin II induce changes in the phenotype of mesangial cells and the composition of matrix they secrete. Together, glucose, insulin, and angiotensin II conspire to produce an unrelenting increase in accumulation of mesangial matrix, with altered composition and function.
糖尿病肾病是糖尿病患者发病和死亡的主要原因，其特征是系膜基质逐渐扩张，最终阻塞肾小球毛细血管。糖尿病异常代谢环境中的多种因素导致系膜基质量增加。葡萄糖刺激系膜中正常表达的大多数胶原蛋白和基质糖蛋白的合成增加。基质蛋白的异常糖基化会干扰其降解和周转。高胰岛素血症期和血管紧张素II的改变会诱导系膜细胞表型及其分泌的基质组成发生变化。葡萄糖、胰岛素和血管紧张素II共同作用，导致系膜基质积累持续增加，其组成和功能发生改变。
