Endothelium as a Therapeutic Target in Diabetes Mellitus: From Basic Mechanisms to Clinical Practice

doi:10.2174/0929867326666190119154152
摘要

内皮通过调节动脉血压，分配营养素和激素以及提供调节凝血，纤维蛋白溶解和炎症的光滑表面，在人类体内平衡中起着至关重要的作用。血管内皮功能障碍存在于糖尿病（DM）中，并有助于大血管疾病的发展和进展，同时也与大多数微血管并发症（如糖尿病性视网膜病，肾病和神经病）有关。高血糖，胰岛素抵抗，高胰岛素血症和血脂异常是内皮功能障碍发病机理中的主要因素。关于抗糖尿病药物，二甲双胍，格列齐特，吡格列酮，艾塞那肽和达格列净对血管内皮功能（EF）产生有益作用；格列美脲和格列本脲，二肽基肽酶-4抑制剂和利拉鲁肽具有中性作用，而研究胰岛素类似物，依帕列净和卡那列净对EF影响的研究有限。在降脂药物方面，他汀类药物可改善DM患者的EF，而短期试验的数据表明非诺贝特可改善EF。依折麦布也可以改善EF，但需要对DM患者进行进一步的研究。乙酰水杨酸对EF的作用是剂量依赖性的，较低的剂量可以改善EF，而较高的剂量则不能。氯吡格雷可改善EF，但需要在DM受试者中进行更多研究。此外，血管紧张素转化酶抑制剂/血管紧张素II受体阻滞剂可改善EF。 5型磷酸二酯酶抑制剂可改善海绵体中的EF。最后，西洛他唑对EF有良好的作用，但是，DM患者还需要更多数据。
关键词: 内皮，糖尿病，糖尿病并发症，抗糖尿病药，降脂药，抗血小板药，降压药。
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DOI https://dx.doi.org/10.2174/0929867326666190119154152	Print ISSN 0929-8673
Publisher Name Bentham Science Publisher	Online ISSN 1875-533X
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