糖尿病加速肌腱病进展的致病机制研究进展

Research progress on pathogenesis of diabetes accelerating the progression of tendinosis

目的检索搜集既往有关糖尿病影响肌腱病进展的相关文献,总结相关结论并讨论糖尿病加速肌腱病进展的发病机制,主要包括概述糖尿病患者病变肌腱的生物力学改变与组织学变化,以及其从细胞分子水平上的发病机制等方面的问题。方法通过检索PubMed、Springer Link、中国知网(CNKI)、谷歌学术等中英文数据库,查阅并分析涉及与糖尿病肌腱病相关领域的国内外文献。结果以往大多数研究更支持退变学说作为肌腱病的发病机制,但目前越来越多研究者发现糖尿病作为一种全身性的代谢性疾病,可通过多种机制诱发或加重肌腱病的进展,如晚期糖基化终末产物(AGEs)在病变部位处沉积、病变部位慢性炎症反应、肌腱细胞氧化应激水平上升、基质金属蛋白酶和谷氨酰胺转氨酶活性的改变等。通过概述分析既往研究者们提出的糖尿病对肌腱病的相关致病机制的多种理解,糖尿病与肌腱病之间的关系逐渐明确。结论作为一种全身性的代谢性疾病,糖尿病可通过多种途径和机制诱发或加重肌腱病的进展,通过研究和阐明这些途径可以为我们研究和治疗肌腱病提供有力武器。但目前糖尿病肌腱病可能存在的发病途径繁多,仍需逐步开展研究以进一步明确其主要发病机制。

Objective Search and collect the previous relevant literature on the influence of diabetes on the progress of tendinosis,summarize the relevant conclusions and discuss the pathogenesis of diabetes accelerating the progress of tendinosis,mainly including summarizing the biomechanical and histological changes of diseased tendons in diabetes patients,as well as its pathogenesis at the cellular level.Methods This paper reviewed and analyzed the domestic and foreign literature related to diabetes tendinosis by searching some Chinese and English databases like PubMed,Springer Link,CNKI,Google Academic.Results Most previous studies more support the theory of degeneration as the pathogenesis of tendinosis,but now more and more researchers find that diabetes,as a systemic metabolic disease,can induce the occurrence of tendinosis through a variety of mechanisms,or aggravate the progress of tendinosis,such as the accumulation of advanced glycation end products(AGEs)at the lesion site,chronic inflammatory reaction at the lesion site,increased oxidative stress level of tendon cells And changes in the activities of matrix metalloproteinases and glutamine transaminase.By summarizing and analyzing the various understandings of diabetes on the pathogenesis of tendinosis proposed by previous researchers,the relationship between diabetes and tendinosis is gradually clear.Conclusion As a systemic metabolic disease,diabetes can induce the occurrence of tendinosis or aggravate the progress of tendinosis through a variety of ways and mechanisms.Research and clarification of these ways can provide us with a powerful weapon to study and treat tendinosis.However,at present,there are many possible pathogenesis of diabetes tendinosis,which still needs to be studied step by step to further clarify its main pathogenesis.