糖尿病病理生理中多巴胺能系统的破坏

Y. Bykov, V. Baturin
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摘要

介绍。糖尿病(DM)是最常见的内分泌疾病,发病率高,并发症多。本研究的目的是从病理生理角度对糖尿病中多巴胺能功能障碍的现状进行分析性文献综述。材料和方法。检索Cochrane图书馆,PubMed,图书馆,Medscape数据库和数字图书馆,检索词:糖尿病,多巴胺,胰岛素,多巴胺能系统,糖尿病性脑病。总共选择了66个来源进行审查。结果和讨论。多巴胺能系统功能障碍被认为是糖尿病病理生理的重要组成部分。糖尿病患者多巴胺(DA)产生的过度激活抑制胰岛素合成,导致高血糖。另一方面,低胰岛素血症引发多巴胺能系统的激活,形成恶性循环。糖尿病中DA的增加在继发性中枢神经系统功能障碍的发展中起重要作用,主要是通过脑供血不足的发展。许多临床前研究证实了糖尿病患者多巴胺能系统的功能障碍(其激活)。关于这方面的临床研究很少,需要进一步的研究。糖尿病多巴胺能系统功能障碍是糖尿病症状性神经系统疾病病理生理学研究的一个重要领域。1型和2型糖尿病是病理上不同的疾病,因此DA生成受损可能是由于1型糖尿病患者胰岛素缺乏、表现时间不同、2型糖尿病患者高胰岛素血症和胰岛素抵抗所致。找到可靠的方法来诊断多巴胺能系统的功能障碍,可以提高对糖尿病神经内分泌系统中正在进行的病理过程的理解,这对于除病理治疗外解决其纠正问题非常重要。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Disruption of the dopaminergic system in the pathophysiology of diabetes mellitus
Introduction. Diabetes mellitus (DM) is the most common endocrinopathy with a high incidence and a high number of complications.The aim of this work was to conduct an analytical literature review assessing the state of the problem of dopaminergic dysfunction in diabetes from a pathophysiological perspective.Materials and methods. Searching Cochrane Library, PubMed, eLibrary, Medscape databases and digital libraries using the search words: diabetes mellitus, dopamine, insulin, dopaminergic system, diabetic encephalopathy. A total of 66 sources were selected for the review.Results and discussion. Dopaminergic system dysfunction can be considered an important component of the pathophysiology of diabetes. Hyperactivation of dopamine (DA) production in the setting of diabetes inhibits insulin synthesis, resulting in hyperglycemia. On the other hand, hypoinsulinemia triggers activation of the dopaminergic system, forming a vicious circle. Increased DA production in diabetes plays an important role in the development of secondary central nervous system dysfunction, primarily through the development of cerebral insufficiency. Numerous preclinical studies confirm the dysfunction of the dopaminergic system (its activation) in diabetes. Clinical studies on this issue are scarce and require further investigation.Conclusion. Dysfunction of the dopaminergic system in diabetes is an important area of research into the pathophysiology of symptomatic neurological disorders in this disease. Type 1 and type 2 diabetes are pathogenetically different diseases, and therefore impaired DA production may be due to insulin deficiency in patients with type 1 diabetes, different timing of manifestation, with hyperinsulinemia and insulin resistance in type 2 diabetes. Finding reliable methods to diagnose dysfunction of the dopaminergic system may improve understanding of the ongoing pathological processes in the neuroendocrine system in diabetes, which is important in addressing their correction in addition to pathogenetic therapy.
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