Rối loạn chức năng nội mô và bệnh tiểu đường: vai trò của tăng đường huyết, suy giảm tín hiệu insulin và béo phì

Springer Science and Business Media LLC - Tập 335 - Trang 165-189 - 2008
Wineke Bakker1, Etto C. Eringa1, Pieter Sipkema1, Victor W. M. van Hinsbergh1
1Laboratory of Physiology, Institute for Cardiovascular Research, VU University Medical Center, Amsterdam, The Netherlands

Tóm tắt

Rối loạn chức năng nội mô bao gồm một số thay đổi chức năng trong nội mô mạch máu liên quan đến bệnh tiểu đường và bệnh tim mạch, bao gồm những thay đổi trong điều hòa mạch máu, tăng cường sản sinh các gốc tự do oxy, kích hoạt viêm và thay đổi chức năng hàng rào. Tăng đường huyết là đặc điểm nổi bật của bệnh tiểu đường loại 1 và loại 2 và đóng vai trò quan trọng trong các biến chứng vi mạch liên quan đến bệnh tiểu đường. Mặc dù tăng đường huyết cũng đóng góp vào sự xuất hiện và tiến triển của bệnh vi mạch (nguyên nhân chính gây tử vong ở bệnh tiểu đường loại 2), các yếu tố khác như rối loạn lipid máu, tăng insulin trong máu và các yếu tố phát sinh từ mô mỡ đóng vai trò quan trọng hơn. Sự tương tác lẫn nhau giữa các yếu tố này và rối loạn chức năng nội mô xảy ra trong quá trình tiến triển của bệnh. Chúng tôi đặc biệt chú ý đến khả năng tham gia của stress lưới nội (stress ER) và vai trò của béo phì cùng với các adipokine phát sinh từ mô mỡ như là những yếu tố góp phần vào rối loạn chức năng nội mô trong bệnh tiểu đường loại 2. Sự tương tác gần gũi của các tế bào mỡ của mô mỡ xung quanh mạch với các động mạch và tiểu động mạch tạo điều kiện cho sự tiếp xúc của tế bào nội mô với các adipokine, đặc biệt khi viêm kích hoạt mô mỡ, từ đó ảnh hưởng đến điều hòa mạch và sự thu hút mao mạch trong cơ. Do đó, sự rối loạn chức năng ban đầu của tế bào nội mô là nền tảng cho những thay đổi chuyển hóa và mạch máu góp phần vào sự phát triển của bệnh tiểu đường loại 2.

Từ khóa

#rối loạn chức năng nội mô #bệnh tiểu đường #tăng đường huyết #rối loạn tín hiệu insulin #béo phì

Tài liệu tham khảo

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