伴脂代谢紊乱的糖尿病视网膜病变研究进展

Research progress of diabetic retinopathy with dyslipidemia

糖尿病视网膜病变（DR）是糖尿病主要的微血管病变之一，已成为发达国家成年糖尿病患者可预防性失明的常见原因。脂代谢紊乱是一种系统性疾病，是心血管疾病的主要危险因素之一。糖尿病患者容易发生血脂异常，许多研究证明脂代谢紊乱可加快DR进展，加重DR病情，使DR的治疗更加困难。对脂代谢紊乱加重DR的机制研究为通过改善脂代谢紊乱来治疗和预防DR提供了新的途径和思路。目前已有研究表明，脂代谢紊乱可能通过加重线粒体损伤、胰岛素抵抗、炎症反应、蛋白激酶C/糖基化终末产物通路等途径加重DR的发展，而对他汀类和贝特类等降脂药物及其他降脂措施的研究证明降脂对DR的治疗有积极作用。本文将从伴脂代谢紊乱DR的临床特点、脂代谢紊乱加重DR的潜在机制、降脂治疗对DR的影响几个方面就伴脂代谢紊乱的DR的研究进展进行综述。

Diabetic retinopathy （DR） is one of the major microvascular complications of diabetes, it is the most common cause of preventable blindness in diabetic adults in developed countries. Dyslipidemia, a systemic disease,is one of the most important risk factors for cardiovascular disease. Patients witla diabetes are susceptibly suffering from dyslipidemia. Many studies have shown that dyslipidemia can accelerate the progression of DR and aggravate the condition of DR,making the treatment of DR more difficult. The study on the mechanism of dyslipidemia aggravating DR provides a new way to treat and prevent DR by improving dyslipidemia. Current researches have shown that dyslipidemia may accelerate the progression of DR by exacerbating mitochondrial damage, insulin resistance, inflammatory response,and PKC/AGE pathway. Studies on lipidAowering drugs,such as statins and fibrates and other lipid-lowering measures have shown that lipid-lowering is positive in the treatment of DR. This review summarizes the research progress of DR with dyslipidemia from the clinical features, potential mechanism and the effect of lipid- lowering measures on DR.