Diabetic retinopathy as a sentinel of systemic vascular dysfunction: Shared molecular mechanisms with cardiovascular disease

IF 2.7 2区医学 Q1 OPHTHALMOLOGY

Experimental eye research Pub Date : 2025-09-18 DOI:10.1016/j.exer.2025.110644

Ting Wang, Hongyu Li, Chuyao Wang, Xiuyun Li, Aijun Deng, Xinwei Jiao

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引用次数: 0

Abstract

Diabetic retinopathy (DR) and cardiovascular disease (CVD) represent interconnected complications of diabetes, bound by overlapping pathophysiological processes and epidemiological correlations. This review explores their interplay, highlighting hyperglycemia-driven oxidative stress, chronic inflammation, endothelial dysfunction, and advanced glycation end-products (AGEs)-receptor for AGEs (RAGE) axis activation, which contribute to retinal microvascular damage and systemic atherosclerosis. Severe DR markedly increases CVD risk, positioning it as a marker of vascular pathology. Therapies targeting these pathways, including intensive glycemic control, glucagon-like peptide-1 receptor agonists (GLP-1RAs), sodium-glucose cotransporter-2 inhibitors (SGLT2is), fenofibrate, and renin-angiotensin-aldosterone system (RAAS) inhibitors, offer dual benefits, slowing DR progression and reducing CVD events. Multidisciplinary strategies integrating retinal screening with CVD risk management enhance patient care. Challenges include clarifying causality and improving risk tools. Future research should prioritize causal mechanisms, biomarkers, and personalized treatments to prevent vision loss and cardiovascular morbidity in diabetes.

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糖尿病视网膜病变作为全身血管功能障碍的前哨：与心血管疾病共享的分子机制。

糖尿病视网膜病变（DR）和心血管疾病（CVD）是糖尿病相互关联的并发症，由重叠的病理生理过程和流行病学相关性联系在一起。这篇综述探讨了它们之间的相互作用，强调高血糖驱动的氧化应激、慢性炎症、内皮功能障碍和晚期糖基化终产物(AGEs)- AGEs受体（RAGE）轴激活，这有助于视网膜微血管损伤和系统性动脉粥样硬化。严重DR显著增加CVD风险，将其定位为血管病理的标志。针对这些途径的治疗，包括强化血糖控制、胰高血糖素样肽-1受体激动剂（GLP-1RAs）、钠-葡萄糖共转运蛋白-2抑制剂（SGLT2is）、非诺贝特和肾素-血管紧张素-醛固酮系统（RAAS）抑制剂，提供双重益处，减缓DR进展和减少CVD事件。将视网膜筛查与心血管疾病风险管理相结合的多学科策略可提高患者护理水平。挑战包括澄清因果关系和改进风险工具。未来的研究应优先考虑糖尿病的因果机制、生物标志物和个性化治疗，以预防视力丧失和心血管疾病。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Experimental eye research 医学-眼科学

CiteScore

6.80

自引率

5.90%

发文量

323

审稿时长

66 days

期刊介绍： The primary goal of Experimental Eye Research is to publish original research papers on all aspects of experimental biology of the eye and ocular tissues that seek to define the mechanisms of normal function and/or disease. Studies of ocular tissues that encompass the disciplines of cell biology, developmental biology, genetics, molecular biology, physiology, biochemistry, biophysics, immunology or microbiology are most welcomed. Manuscripts that are purely clinical or in a surgical area of ophthalmology are not appropriate for submission to Experimental Eye Research and if received will be returned without review.