Pathogenesis and Drug Intervention of Diabetic Cardiomyopathy： A Review

Hong-na TONG; Chen-yang ZHANG; Mei-xin HAN; Gui-bo SUN; Xiao-bo SUN

doi:10.13422/j.cnki.syfjx.20220101

您当前的位置：

首页 >

文章列表页 >

Pathogenesis and Drug Intervention of Diabetic Cardiomyopathy： A Review

更新时间：2021-12-14

- Pathogenesis and Drug Intervention of Diabetic Cardiomyopathy： A Review
- Chinese Journal of Experimental Traditional Medical Formulae Vol. 28, Issue 2, Pages: 257-265(2022)
- 作者机构：
  
  1.中国医学科学院北京协和医学院药用植物研究所，北京 100193
  2.哈尔滨商业大学药物工程技术研究中心，哈尔滨 150076
- 作者简介：
- 基金信息：
- DOI：10.13422/j.cnki.syfjx.20220101
  CLC： R2-0;R22;R285.5;R284;R33
- Published：20 January 2022，
  
  Published Online：15 November 2021，
  
  Received：25 August 2021，
- 稿件说明：
扫描看全文
佟红娜,张晨阳,韩美欣等.糖尿病心肌病的发病机制及药物干预研究进展[J].中国实验方剂学杂志,2022,28(02):257-265.

TONG Hong-na,ZHANG Chen-yang,HAN Mei-xin,et al.Pathogenesis and Drug Intervention of Diabetic Cardiomyopathy： A Review[J].Chinese Journal of Experimental Traditional Medical Formulae,2022,28(02):257-265.
佟红娜,张晨阳,韩美欣等.糖尿病心肌病的发病机制及药物干预研究进展[J].中国实验方剂学杂志,2022,28(02):257-265. DOI： 10.13422/j.cnki.syfjx.20220101.

TONG Hong-na,ZHANG Chen-yang,HAN Mei-xin,et al.Pathogenesis and Drug Intervention of Diabetic Cardiomyopathy： A Review[J].Chinese Journal of Experimental Traditional Medical Formulae,2022,28(02):257-265. DOI： 10.13422/j.cnki.syfjx.20220101.

摘要

糖尿病心肌病为糖尿病心血管并发症，早期表现为心脏舒张和收缩功能障碍，后期发展为临床心力衰竭，发病率和死亡率高，一直是近年来的研究热点。糖尿病心肌病发病机制复杂，研究发现其发病机制主要与糖代谢失调、脂代谢异常、心脏胰岛素抵抗、线粒体功能障碍、钙平衡调节异常、肾素-血管紧张素-醛固酮系统激活、氧化应激增加、内质网应激、炎症、自噬等有关，具体发病机制尚不明确。当前的治疗方法主要为西医药治疗和中医药治疗。传统西药治疗糖尿病心肌病尚无特效药，且存在一定的不良反应和副作用。为了提高药效，降低副作用，研究人员发现了一些潜在的西药治疗方法，如丝氨酸蛋白酶抑制剂（Vaspin），褪黑素，辅酶Q10（Coenzyme Q10），非编码RNA等，仍需进一步临床试验研究。中医古籍未曾记载糖尿病心肌病，现代医家根据其症状、体征，常将其归于“消渴病”范畴。中医药治疗消渴病以益气补阴，活血化瘀为主要治疗原则，黄芪、丹参等单味中药和豁痰解毒通络饮等中药复方均能对心脏起到一定的保护作用，但中药药效机制方面的研究较少且不够深入。随着新的治疗药物不断出现，中西医结合治疗或许为未来更加有前景的治疗方法。综上，糖尿病心肌病的发病机制尚未明确，缺少有效的预防和治疗方法。该综述对糖尿病心肌病最新的发病机制和药物治疗方法进行整理和总结，以期为研究人员提供参考。

Abstract

Diabetic cardiomyopathy， one of the cardiovascular complications of diabetes， is characterized by cardiac systolic and diastolic dysfunction at the early stage， which can later develop into heart failure. Due to the high incidence and mortality， it has been a hot topic in recent years. The pathogenesis of diabetic cardiomyopathy is complicated. It has been proved related to abnormal glucose and lipid metabolism， cardiac insulin resistance， mitochondrial dysfunction， abnormal calcium homeostasis， activation of renin-angiotensin-aldosterone system， increased oxidative stress， endoplasmic reticulum stress， inflammation， autophagy， and so on. The specific pathogenesis remains unclear. Currently， the diabetic cardiomyopathy is mainly tackled with both western medicine and traditional Chinese medicine （TCM）. Traditional western medicine has no specific remedy for diabetic cardiomyopathy， and the resulting side effect cannot be neglected. In order to improve the efficacy and reduce the side effects， researchers have tried some potential medical treatments， such as vaspin， melatonin， Coenzyme Q10， and non-coding RNA， which still need further clinical trials. Diabetic cardiomyopathy is not recorded in ancient TCM books. According to the symptoms and signs， modern physicians often consider it as a "consumptive disease"， whose main therapeutic principles lie in benefiting Qi， tonifying Yin， activating blood， and removing stasis. The individual Chinese herbs such as Astragali Radix and Salviae Miltiorrhizae Radix et Rhizoma and Chinese herbal compounds like Huotan Jiedu Tongluoyin are effective in protecting the heart. But there are few studies exploring the pharmacodynamic mechanisms of TCM. With the continuous emergence of new drugs， the integration of TCM with western medicine may be a more promising treatment in the future. In conclusion， the pathogenesis of diabetic cardiomyopathy is unclear， and there is a lack of effective prevention and treatment. This paper reviewed the latest findings in pathogenesis and treatment of diabetic cardiomyopathy， in order to provide reference for further research.

关键词

糖尿病并发症糖尿病心肌病发病机制药物治疗

Keywords

diabetic complicationsdiabetic cardiomyopathypathogenesisdrug therapy

references

CHO N H，SHAW J E，KARURANGA S，et al.IDF Diabetes Atlas：global estimates of diabetes prevalence for 2017 and projections for 2045［J］.Diabetes Res Clin Pract，2018，138：271-281.

GRUBIĆ ROTKVIĆ P，PLANINIĆ Z，LIBERATI PRŠO A，et al.the mystery of diabetic cardiomyopathy：from early concepts and underlying mechanisms to novel therapeutic possibilities［J］.Int J Mol Sci，2021，22（11）：5973.

TAN Y，ZHANG Z G，ZHENG C，et al.Mechanisms of diabetic cardiomyopathy and potential therapeutic strategies：preclinical and clinical evidence［J］.Nat Rev Cardiol，2020，17（9）：585-607.

王丽君.糖尿病性心肌病的中西医研究概况［J］.甘肃医药，2021，40（6）：486-489.

QIN M，LUO Y，LU S，et al.Ginsenoside F1 ameliorates endothelial cell inflammatory injury and prevents atherosclerosis in mice through A20-Mediated Suppression of NF-κB signaling arthropod management tests［J］.Front Pharmacol，2017，8：953.

ZHOU P，XIE W J，SUN Y F，et al.Ginsenoside Rb1 and mitochondria：a short review of the literature［J］.Mol Cell Probes，2019，43：1-5.

ZHOU P，XIE W J，HE S B，et al.Ginsenoside Rb1 as an anti-diabetic agent and its underlying mechanism analysis［J］.Cells，2019，8（3）：204.

JIA G H，HILL M A，SOWERS J R.Diabetic Cardiomyopathy：an update of mechanisms contributing to this clinical entity［J］.Circ Res，2018，122（4）：624-638.

潘余楠，王亚萍.糖尿病心肌病的发病机制研究进展［J］.心电与循环，2019，38（6）：526-530.

BUGGER H，ABEL E D.Molecular mechanisms of diabetic cardiomyopathy［J］.Diabetologia，2014，57（4）：660-671.

KANAMORI H，NARUSE G，YOSHIDA A，et al.Morphological characteristics in diabetic cardiomyopathy associated with autophagy［J］.J Cardiol，2021，77（1）：30-40.

JIA G H，WHALEY-CONNELL A，SOWERS J R.Diabetic cardiomyopathy：a hyperglycaemia- and insulin-resistance-induced heart disease［J］.Diabetologia，2018，61（1）：21-28.

MARFELLA R，SARDU C，MANSUETO G，et al.Evidence for human diabetic cardiomyopathy［J］.Acta Diabetol，2021，58（8）：983-988.

JIA G H，DEMARCO V G，SOWERS J R.Insulin resistance and hyperinsulinaemia in diabetic cardiomyopathy［J］.Nat Rev Endocridol，2016，12（3）：144-153.

LEE T，BAI K，LEE T，et al.PPARs modulate cardiac metabolism and mitochondrial function in diabetes［J］.J Biomed Sci，2017，24（1）：5.

KENNY H C，ABEL E D.Heart failure in type 2 diabetes mellitus［J］.Circ Res，2019，124（1）：121-141.

YIN Z，ZHAO Y，HE M，et al.MiR-30c/PGC-1β protects against diabetic cardiomyopathy via PPARα［J］.Cardiovasc Diabetol，2019，18（1）：7.

EVANGELISTA I，NUTI R，PICCHIONI T，et al.Molecular dysfunction and phenotypic derangement in diabetic cardiomyopathy［J］.Int J Mol Sci，2019，20（13）：3264.

ZHANG J，ZHANG M，YANG Z，et al.PDCD4 deficiency ameliorates left ventricular remodeling and insulin resistance in a rat model of type 2 diabetic cardiomyopathy［J］.BMJ Open Diabetes Res，2020，8（1）：e1081.

陈茉，文颖娟，赵欢，等.中医药调控线粒体质量控制治疗糖尿病心肌病研究进展［J］.中国实验方剂学杂志，2021，doi：10.13422/j.cnki.syfjx.20211316http://dx.doi.org/10.13422/j.cnki.syfjx.20211316.

ANDERSON E J，RODRIGUEZ E，ANDERSON C A，et al.Increased propensity for cell death in diabetic human heart is mediated by mitochondrial-dependent pathways［J］.Am J Physiol Heart Circ Physiol，2011，300（1）：H118-H124.

BYRNE N J，RAJASEKARAN N S，ABEL E D，et al.Therapeutic potential of targeting oxidative stress in diabetic cardiomyopathy［J］.Free Radical Bio Med，2021，169：317-342.

MARWICK T H，RITCHIE R，SHAW J E，et al.Implications of underlying mechanisms for the recognition and management of diabetic cardiomyopathy［J］.J Am Coll Cardiol，2018，71（3）：339-351.

RIEHLE C，BAUERSACHS J.Of mice and men：models and mechanisms of diabetic cardiomyopathy［J］.Basic Res Cardiol，2018，114（1）：2.

HU J，LU X，ZHANG X，et al.Exogenous spermine attenuates myocardial fibrosis in diabetic cardiomyopathy by inhibiting endoplasmic reticulum stress and the canonical Wnt signaling pathway［J］.Cell Biol Int，2020，44（8）：1660-1670.

RITCHIE R H，ABEL E D.Basic mechanisms of diabetic heart disease［J］.Circ Res，2020，126（11）：1501-1525.

LI G，YANG L，FENG L，et al.Syringaresinol protects against type 1 diabetic cardiomyopathy by alleviating inflammation responses，cardiac fibrosis，and oxidative stress［J］.Mol Nutr Food Res，2020，64（18）：2000231.

黄芷棋，宁一博，贺润铖，等.NLRP3炎性小体与糖尿病心肌病的发生发展［J］.中国药理学通报，2021，37（4）：463-467.

DEWANJEE S，VALLAMKONDU J，KALRA R S，et al.Autophagy in the diabetic heart：a potential pharmacotherapeutic target in diabetic cardiomyopathy［J］.Ageing Res Rev，2021，68：101338.

PACKER M.Longevity genes，cardiac ageing，and the pathogenesis of cardiomyopathy：implications for understanding the effects of current and future treatments for heart failure［J］.Eur Heart J，2020，41（39）：3856-3861.

SONG Y，ZHONG C，WU W.Resveratrol and diabetic cardiomyopathy：focusing on the protective signaling mechanisms［J］.Oxid Med Cell Longev，2020，doi：10.1155/2020/7051845http://dx.doi.org/10.1155/2020/7051845.

KNAPP M，TU X，WU R.Vascular endothelial dysfunction，a major mediator in diabetic cardiomyopathy［J］.Acta Pharmacol Sin，2019，40（1）：1-8.

SHOME J S，PERERA D，PLEIN S，et al.Current perspectives in coronary microvascular dysfunction［J］.Microcirculation，2017，24（1）：e12340.

李婉娇，李强.糖尿病性心肌病的发病机制及治疗方法研究进展［J］.中华老年多器官疾病杂志，2019，18（7）：536-539.

PARIM B，SATHIBABU U V，SARAVANAN G.Diabetic cardiomyopathy：molecular mechanisms，detrimental effects of conventional treatment，and beneficial effects of natural therapy［J］.Heart Fail Rev，2019，24（2）：279-299.

SEFEROVIC P M，COATS A J S，PONIKOWSKI P，et al.European Society of Cardiology/Heart Failure Association position paper on the role and safety of new glucose-lowering drugs in patients with heart failure［J］.Eur J Heart Fail，2020，22：196-213.

MURTAZA G，VIRK H U H，KHALID M，et al.Diabetic cardiomyopathy-a comprehensive updated review［J］.Prog Cardiovasc Dis，2019，62（4）：315-326.

LI X，KE X，LI Z，et al.Vaspin prevents myocardial injury in rats model of diabetic cardiomyopathy by enhancing autophagy and inhibiting inflammation［J］.Biochem Biophys Res Commun，2019，514（1）：1-8.

CHE H，WANG Y，LI H，et al.Melatonin alleviates cardiac fibrosis via inhibiting lncRNA MALAT1/miR-141-mediated NLRP3 inflammasome and TGF-β1/Smads signaling in diabetic cardiomyopathy［J］.The Faseb Journal，2020，34（4）：5282-5298.

SONG Y J，ZHONG C B，WU W.Cardioprotective effects of melatonin：focusing on its roles against diabetic cardiomyopathy［J］.Biomed Pharmacother，2020，128：110260.

LUCAS T，BONAUER A，DIMMELER S.RNA therapeutics in cardiovascular disease［J］.Circ Res，2018，123（2）：205-220.

WAN H，ZHAO S，ZENG Q，et al.CircRNAs in diabetic cardiomyopathy［J］.Clin Chim Acta，2021，517：127-132.

NAIR N，GONGORA E.Stem cell therapy in heart failure：where do we stand today？［J］.Biochim Biophys Acta Mol Basis Dis，2020，1866（4）：165489.

宋玲，赵泉霖.中医药防治糖尿病心肌病的研究探讨［J］.中国中西医结合影像学杂志，2021，19（3）：298-300.

李嘉钰，闫康，赵泉霖.芪归药对治疗糖尿病心肌病的理论探讨［J］.辽宁中医杂志，2021，48（2）：69-71.

卢伟炽，许帅，朱章志，等.2型糖尿病中医临床路径的应用效果［J］.世界中医药，2019，14（6）：1594-1597.

王文越，刘珊，吕琴，等.黄芪-当归药对益气活血药理作用研究进展［J］.中国实验方剂学杂志，2021，27（6）：207-216.

孙奇林，鞠婧，王浩，等.黄芪多糖干预糖尿病心肌氧化应激的实验研究［J］.中国中西医结合杂志，2020，40（2）：196-203.

王怡茹，韦婧，张一凡，等.黄芪中药制剂治疗糖尿病心肌病疗效的系统评价和Meta分析［J］.世界中医药，2020，15（18）：2717-2725，2734.

吕旻，常晓，林惠卿，等.活血降糖饮调控糖尿病心肌病线粒体自噬的作用研究［J］.世界中医药，2020，15（24）：3777-3781.

赵灿，杨金伟，吴勇军，等.基于网络药理学知母-黄柏药对治疗糖尿病作用机制［J］.世界中医药，2020，15（22）：3369-3374，3382.

ACHETE DE SOUZA G，DE MARQUI S V，MATIAS J N，et al.Effects of Ginkgo biloba on diseases related to oxidative stress［J］.Planta Med，2020，86（6）：376-386.

Al HROOB A M，ABUKHALIL M H，HUSSEIN O E，et al.Pathophysiological mechanisms of diabetic cardiomyopathy and the therapeutic potential of epigallocatechin-3-gallate［J］.Biomed Pharmacother，2019，109：2155-2172.

JUBAIDI F F，ZAINALABIDIN S，TAIB I S，et al.The potential role of flavonoids in ameliorating diabetic cardiomyopathy via alleviation of cardiac oxidative stress，inflammation and apoptosis［J］.Int J Mol Sci，2021，22（10）：5094.

王世长，李靖，彭博，等.基于数据挖掘中药复方治疗糖尿病用药规律探究［J］.世界中医药，2019，14（6）：1429-1438.

石锐，常立萍.豁痰解毒通络饮对糖尿病心肌病患者NT-proBNP水平、心功能及心室重构的影响［J］.中医学报，2020，35（260）：176-180.

田春礼，杨莉丽.黄芪养血方对糖尿病心肌病心功能不全患者心脏功能、血糖及中医症状的影响［J］.实用糖尿病杂志，2020，16（5）：104-106.

杨金伟，赵灿，吴勇军，等.基于网络药理学探讨丹参饮治疗糖尿病心肌病的分子机制［J］.中国中医药信息杂志，2020，27（308）：78-83.

马韵之，李剑，周鹏.糖尿病心肌病血清生物标志物研究进展［J］.心血管病学进展，2021，42（234）：392-395.

RODRÍGUEZ-CALVO R，GIRONA J，RODRÍGUEZ M，et al.Fatty acid binding protein 4 （FABP4） as a potential biomarker reflecting myocardial lipid storage in type 2 diabetes［J］.Metabolism，2019，96：12-21.

SØRENSEN M H，BOJER A S，JØRGENSEN N R，et al.Fibroblast growth factor-23 is associated with imaging markers of diabetic cardiomyopathy and anti-diabetic therapeutics［J］.Cardiovasc Diabetol，2020，19（1）：158.

王鹏，郑乐民，祖凌云.巨噬细胞在糖尿病心肌病发病中的作用［J］.生理科学进展，2020，51（4）：15-18.

Views

下载量

CSCD

Alert me when the article has been cited

提交

Tools

Publicity Resources

Pathogenesis and Drug Therapy in Traditional Chinese and Western Medicine of Postpartum Lochia：A Review

Action Mechanism of Chinese Medicine Polysaccharides in Prevention and Treatment Diabetes and Its Complications：A Review

Pathogenesis of Diabetic Cardiomyopathy and Overview Traditional Chinese Medicine Treatment

Traditional Chinese Medicine Treatment for Diabetes and Its Complications： A Review

Pathogenesis of Idiopathic Pulmonary Fibrosis and Modulating Effect of Chinese Medicine： A Review

Related Author

LIU Xingtong

LIU Yanfeng

YAN Fei

PANG Ying

Feng CHEN

Fan ZHANG

Er-wei HAO

Liu-ying MO

Related Institution

Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine

Headquarters of Beijing Nuclear Industry Hospital

Guangxi University of Chinese Medicine Guangxi Key Laboratory of Efficacy Study on Chinese Meteria，Guangxi Collaborative Innovation Center of Study on Functional Ingredients of Agricultural Residues，Guangxi Scientific Research Center of Traditional Chinese Medicine

Institute of Chinese Materia Medica，China Academy of Chinese Medical Sciences

Jiangxi University of Chinese Medicine

Postal code：100700
Tel：010-84076882 Email：syfjx_2010@188.com
Technical support is provided by Beijing Founder electronics co., LTD 京ICP备11006657号-10 京公网安备11010802024621
It is recommended to read the content of this site in Chrome&IE9+. Please switch to extreme mode in browser 360.
Cookies We use cookies to help provide and enhance our service and tailor content. By continuing, you agree to the use of cookies.

⁰