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Cardiomyopathy associated with noninsulin-dependent diabetes 总被引:2,自引:0,他引:2
Stephen W. Schaffer 《Molecular and cellular biochemistry》1991,107(1):1-20
Summary Cardiovascular disease represents the major cause of morbidity and mortality in noninsulin-dependent diabetic patients. While
it was once thought that atherosclerotic vascular disease was responsible for all of these adverse effects, recent studies
support the notion that one of the major adverse complications of diabetes is the development of a diabetic cardiomyopathy
characterized by defects in both diastolic and systolic function. Contributing to the development of the cardiomyopathy is
a shift in myosin isozyme content in favor of the least active V3 form. Also defective in the noninsulin-dependent diabetic heart is regulation of calcium homeostasis. While transport of
calcium by the sarcolemmal and sarcoplasmic reticular calcium pumps are minimally affected by noninsulin-dependent diabetes,
significant impairment occurs in sarcolemmal Na+-Ca2+ exchanger activity. This defect limits the ability of the diabetic heart to extrude calcium, contributing to an elevation
in [Ca2+]i. Also promoting the accumulation of calcium by the diabetic cell is a decrease in Na+, K+ ATPase activity, which is known to increase [Ca2+]i secondary to a rise in [Na+]i. In addition, calcium influx via the calcium channel is stimulated. Although the molecular mechanisms underlying these defects
are presently unknown, the possibility that they may be related to aberrations in glucose or lipid metabolism are considered.
The evidence suggests that classical theories of glucose toxicity, such as excessive polyol production or glycosylation, appear
to be insignificant factors in heart. Also insignificant are defects in lipid metabolism leading to accumulation of toxic
lipid amphiphiles or triacylglycerol. Rather, the major defects involve membrane changes, such as phosphatidylethanolamine
N-methylation and protein phosphorylation, which can be attributed to the state of insulin resistance. 相似文献
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Combined clofibrate-chlorpropamide therapy in diabetes insipidus complicated with diabetes mellitus]
The authors observed the incidence of diabetes mellitus and diabetes insipidus in three cases. The combined clofibrat-chlorpropamide treatment proved to be successful. They succeeded in ceasing the daily insuline by giving the two drugs together. The daily diuresis diminished considerably in all three patients. The authors advise the combined clofibrat-chlorpropamide treatment in the incidence of the two diseases. This is especially reasonable when there is a disturbance in the lipoid metabolism. 相似文献
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P. D. Home 《BMJ (Clinical research ed.)》1994,308(6929):611-612
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