Diabetic angiopathy:
Gespeichert in:
| Format: | Buch |
|---|---|
| Sprache: | English |
| Veröffentlicht: |
London [u.a.]
Arnold
1999
|
| Schlagworte: | |
| Online-Zugang: | Inhaltsverzeichnis |
| Beschreibung: | XVI, 304 S. Ill., graph. Darst. |
| ISBN: | 0340741023 |
Internformat
MARC
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| 245 | 1 | 0 | |a Diabetic angiopathy |c ed. by John E Tooke |
| 264 | 1 | |a London [u.a.] |b Arnold |c 1999 | |
| 300 | |a XVI, 304 S. |b Ill., graph. Darst. | ||
| 336 | |b txt |2 rdacontent | ||
| 337 | |b n |2 rdamedia | ||
| 338 | |b nc |2 rdacarrier | ||
| 650 | 4 | |a Arterial Occlusive Diseases | |
| 650 | 4 | |a Diabetic Angiopathies | |
| 650 | 4 | |a Diabetic angiopathies | |
| 700 | 1 | |a Tooke, John E. |e Sonstige |4 oth | |
| 856 | 4 | 2 | |m HBZ Datenaustausch |q application/pdf |u http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&local_base=BVB01&doc_number=009119810&sequence=000002&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA |3 Inhaltsverzeichnis |
| 999 | |a oai:aleph.bib-bvb.de:BVB01-009119810 | ||
Datensatz im Suchindex
| _version_ | 1804128149014839296 |
|---|---|
| adam_text | CONTENTS
List of contributors xiii
Preface by Harry Keen xv
PART ONE: BACKGROUND 1
1 Introduction 3
John E. Tooke and William Liddell
1.1 Historical perspective 3
1.2 Diabetic angiopathy 4
1.3 Scope of the text 5
2 Epidemiology of diabetic angiopathy 7
Rhys Williams and Mark Airey
2.1 Scope of this chapter 7
2.2 Making sense of the epidemiological information 7
2.3 Peripheral vascular disease 8
2.3.1 Definitions 8
2.3.2 Practice based studies 8
2.3.3 Population based studies 9
2.4 Coronary heart disease 9
2.4.1 Definition 9
2.4.2 Practice based studies 10
2.4.3 Population based studies 10
2.5 Cerebrovascular disease 11
2.5.1 Definition 11
2.5.2 Practice based studies 11
2.5.3 Population based studies 12
2.5.4 World wide comparisons 12
2.6 Microvascular disease 12
2.6.1 Definition 12
2.6.2 Clinic based and population based studies 13
2.7 Predicting the future 14
PART TWO: THE PATHOGENESIS OF ARTERIAL DISEASE IN DIABETES 19
3 The atherosclerotic process and its exacerbation by diabetes 21
Hans Joachim Baumgartl and Eberhard Standl
3.1 Atherogenesis 21
vi Contents
3.2 The atherosclerotic process in diabetes 22
3.2.1 Introduction 22
3.2.2 The AGE hypothesis 23
3.2.3 Cytokines and growth factors: TGF p 26
3.2.4 Inositol depletion 26
3.2.5 Heparan sulphate proteoglycan depletion 27
3.2.6 Vascular endothelial growth factor 29
3.3 Future perspectives 30
4 Risk factors for arterial disease in diabetes: hyperglycaemia 37
Amanda I. Adler and H. Andrew W. Neil
4.1 Introduction 37
4.2 Increased risk of cardiovascular disease in diabetes 37
4.3 Role of glycaemia as a cardiovascular risk factor in impaired
glucose tolerance and impaired fasting glucose 39
4.4 Evidence for the independent role of glycaemia 40
4.5 Pathophysiologic basis for the role of glycaemia in atherosclerosis 41
4.6 Clinical implications 41
4.7 Conclusions 42
5 Risk factors for arterial disease in diabetes: hypertension 45
James R. Sowers and Murray Epstein
5.1 Summary 45
5.2 Introduction 45
5.3 Hyperinsulinaemia and cardiovascular disease 47
5.4 Platelet abnormalities associated with diabetes and hypertension 48
5.5 Coagulation abnormalities in diabetic hypertensive persons 48
5.6 Other metabolic abnormalities associated with diabetes mellitus
and hypertension 49
5.7 Abnormalities of non esterified fatty acid metabolism in diabetes
and hypertension 50
5.8 Endothelial dysfunction in diabetes and hypertension 50
5.9 Kidney disease, diabetes and hypertension: analogy between
glomerulosclerosis and atherosclerosis 51
5.10 Treatment of hypertension in patients with diabetes mellitus 53
5.10.1 Goals of therapy 53
5.10.2 Non pharmacological therapy in diabetic hypertensive patients 53
5.10.3 Pharmacological therapy 55
6 Risk factors for arterial disease in diabetes: dyslipidaemia 65
D. John Betteridge
6.1 Introduction 65
6.2 Atherosclerosis related disease in diabetes 66
6.3 The physiology of lipid and lipoprotein transport 66
6.3.1 Exogenous pathway 67
6.3.2 Endogenous lipoprotein pathway 70
Contents vii
6.3.3 High density lipoprotein and reverse cholesterol transport 71
6.3.4 Lipids, lipoproteins and atherosclerosis 72
6.3.5 Lipoprotein(a) 76
6.4 Lipid and lipoprotein metabolism in diabetes 76
6.4.1 NIDDM patients 76
6.4.2 IDDM patients 78
6.4.3 Lipid and lipoprotein levels in relation to diabetic macrovascular disease 78
6.5 Management of dyslipidaemia in diabetic patients 79
6.5.1 Screening 79
6.5.2 Treatment targets 81
6.5.3 Treatment 82
6.5.4 Choice of lipid lowering drugs 84
6.5.5 Choice of lipid lowering therapy 86
6.5.6 An approach to lipid lowering therapy in diabetic patients 87
7 Risk factors for arterial disease in diabetes: coagulopathy 93
Peter J. Grant
7.1 Introduction 93
7.2 Mechanisms in thrombosis 93
7.2.1 Coagulation 93
7.2.2 Fibrinolysis 94
7.2.3 Platelets 95
7.3 Diabetes as a hypercoagulable state 95
7.3.1 Introduction 95
7.3.2 Biochemical evidence for a pro coagulant state in diabetes 96
7.4 Diabetes and atherothrombotic risk 97
7.5 Coagulation 97
7.5.1 Fibrinogen 97
7.5.2 Factor VII 99
7.6 Fibrinolysis 100
7.6.1 Fibrinolysis in NIDDM and IDDM subjects 100
7.6.2 Determinants of fibrinolytic activity in diabetes mellitus 101
7.6.3 Fibrinolysis and vascular disorders 101
7.6.4 Genetics of PAI 1 and diabetes mellitus 101
7.7 Platelets and Von Willebrand factor 102
7.7.1 Platelet function in diabetes mellitus 102
7.7.2 vWF in diabetes mellitus 103
7.8 Conclusions 104
8 Insulin resistance and arterial disease in diabetes: a unifying hypothesis 113
John S. Yudkin
8.1 Introduction 113
8.2 The insulin resistance syndrome: what is it and who belongs? 114
8.2.1 What is insulin resistance? 114
8.2.2 Insulin resistance and the metabolic syndrome 114
8.2.3 The relevance of obesity and physical activity 115
viii Contents
8.2.4 Can insulin resistance explain dyslipidaemia and hypertension? 115
8.2.5 Insulin resistance and CHD 116
8.3 The insulin resistance syndrome club: new applicants for membership 117
8.3.1 Plasminogen activator inhibitor 1 117
8.3.2 Pro insulin like molecules 117
8.3.3 Microalbuminuria 119
8.3.4 Fibrinogen 119
8.4 Insulin resistance and its associates: consequences of a common antecedent? 119
8.5 The small baby syndrome 119
8.6 Endothelial dysfunction as a common antecedent of insulin resistance
and the metabolic cluster 121
8.7 Pro inflammatory cytokines, the acute phase response and insulin resistance 122
8.8 The role of infections and adipose tissue? 125
8.9 A new paradigm for insulin resistance, obesity, endothelial dysfunction
and cardiovascular disease 127
8.10 Conclusions 128
PART THREE: THE PATHOGENESIS OF DIABETIC MICROANGIOPATHY 135
9 The role of glycaemia in the pathogenesis of microangiopathy 137
Kenneth M. MacLeod
9.1 Introduction 137
9.2 The glucose hypothesis 137
9.3 Indirect evidence incriminating glucose in the pathogenesis of microangiopathy 138
9.3.1 Studies of individuals with impaired glucose tolerance and those with
newly diagnosed diabetes 138
9.3.2 Patients with maturity onset diabetes of the young 139
9.3.3 Relationship of microvascular complications to duration of disease and
degree of hyperglycaemia 139
9.3.4 Observational studies: diabetic retinopathy in focus 140
9.3.5 Observational studies: diabetic nephropathy in focus 141
9.4 Interventional studies 142
9.4.1 Animal studies 142
9.4.2 Human studies 142
9.4.3 The evidence in insulin dependent diabetes mellitus 142
9.5 Tight control in type 2 diabetes: the evidence 147
9.6 Glycaemic re entry 150
9.7 Hypoglycaemia and microangiopathy 152
9.8 More than glucose: the missing links? 153
10 The vascular cellular consequences of hyperglycaemia 161
Joseph R. Williamson and Yasuo Ido
10.1 Functional and structural vascular responses to hyperglycaemia 161
10.1.1 Early vascular dysfunction induced by acute hyperglycaemia
in non diabetic humans and rats 161
Contents ix
10.1.2 Early vascular dysfunction in diabetic humans and in animals
with spontaneous or experimentally induced diabetes 162
10.1.3 Vascular structural changes 163
10.2 Pathophysiological significance of increased blood flow and loss of vascular
barrier functional integrity: relationship to vascular structural changes 163
10.3 Metabolic imbalances implicated in mediating vascular changes
induced by hyperglycaemia and the diabetic milieu 164
10.4 Cytosolic free NADH/NAD+ and reductive stress, energy metabolism and
regulation of blood flow 166
10.4.1 Redox cycling of NAD(H) and ATP synthesis 170
10.5 NADPH: co factor for aldose reductase, nitric oxide synthase and glutathione
reductase 171
10.6 Metabolic consequences of cytosolic reductive stress 173
10.6.1 Cytosolic reductive stress, oxidative stress, non enzymatic glycation,
and extracellular matrix changes 173
10.6.2 Cytosolic reductive stress and vascular endothelial growth factor 175
10.6.3 Cytosolic reductive stress, de novo synthesis of diacylglycerol,
and activation of protein kinase C 176
10.6.4 Vascular consequences of cytosolic reductive stress in non vascular
versus vascular cells 177
10.6.5 Cytosolic reductive stress, paradoxical responses to ischaemic injury,
and metabolic suppression 178
10.7 Conclusions 179
11 A pathophysiological framework for the pathogenesis of microangiopathy 187
John E. Tooke
11.1 Introduction 187
11.2 Indirect evidence for microvascular malfunction in diabetes 188
11.3 The haemodynamic hypothesis of diabetic microangiopathy 189
11.3.1 Direct support for the haemodynamic hypothesis 190
11.4 Reduced microvascular vasodilatory reserve 191
11.5 Alternative pathophysiological concepts 191
11.5.1 The role of increased microvascular permeability 191
11.6 The pathophysiology of the microcirculation in non insulin dependent
diabetes 193
11.7 A pathophysiological framework for diabetic microangiopathy 194
12 The endothelium in diabetes 197
Lucilla Poston
12.1 Introduction 197
12.2 Vascular responses to acetylcholine in diabetes 198
12.3 Flow mediated, endothelium dependent, dilation in diabetes 200
12.4 Insulin, NO and insulin resistance 202
12.5 Endothelium dependent constrictors 202
12.6 The diabetic milieu and vascular endothelial function 202
12.6.1 Hyperglycaemia 203
12.6.2 Oxidative stress, lipids and endothelial dysfunction 203
x Contents
13 Blood rheological changes in diabetes 213
Alan Jaap and Gordon D.O. Lowe
13.1 Introduction 213
13.2 Rheological changes in diabetes 213
13.3 White cells and platelets in diabetes 214
13.3.1 White cells 215
13.3.2 Platelets 215
13.4 Rheological, white cell and platelet abnormalities and the pathogenesis of
microangiopathy 215
13.4.1 Early haemodynamic changes 215
13.4.2 Established microvascular disease 215
13.5 Conclusions 216
14 Mechanisms underlying pathophysiological changes in human diabetic
microangiopathy 219
John E. Tooke
14.1 Introduction 219
14.2 The origins of luxury perfusion 219
14.3 The origins of capillary hypertension 221
14.4 Limitation in maximal microvascular hyperaemia 222
14.5 Changes in capillary permeability in diabetes 224
14.5.1 Determinants of capillary wall permeability 224
14.5.2 The molecular basis for increased permeability in diabetes 225
14.6 Conclusions 227
PART FOUR: ORGAN SPECIFIC VASCULAR CHANGES 231
15 Diabetic retinopathy 233
Eva M. Kohner and Rakesh Chibber
15.1 Introduction 233
15.2 The evolution of diabetic retinopathy 233
15.3 Pathogenic mechanisms in diabetic retinopathy 234
15.3.1 Haemodynamic changes 235
15.3.2 Direct effect of hyperglycaemia on retinal vascular cells 238
15.3.3 Capillary occlusion 240
15.3.4 Vascular proliferation 241
16 Diabetic nephropathy 249
Allan Kofoed Enevoldsen
16.1 Introduction 249
16.2 The nature of diabetic renal disease 249
16.3 Morphological changes 250
16.4 Genetic determinants 251
16.5 Haemodynamic changes 251
16.5.1 Renin angiotensin system 252
16.5.2 Hypertension 253
Contents xi
16.6 Glomerular size and charge selectivity 253
16.7 Derangement of the extracellular matrix 254
16.7.1 Heparan sulphate proteoglycan (Steno hypothesis) 255
16.8 Cellular and molecular mechanisms 256
16.8.1 Na+/H+ exchanger and sodium lithium countertransport activity 256
16.8.2 Polyol pathway and pseudohypoxia 256
16.8.3 Non enzymatic glycation 257
16.8.4 Protein kinase C 257
16.8.5 TGF 3 258
16.8.6 Nitric oxide 258
16.8.7 Growth hormone and IGF 1 259
16.8.8 Insulin resistance 259
16.9 Diabetic nephropathy in NIDDM versus IDDM 259
17 Organ specific vascular changes 267
Andrew J.M. Boulton and Rayaz A. Malik
17.1 Introduction 267
17.2 Human structural and functional neurovascular abnormalities 267
17.3 Experimental nerve ischaemia 269
17.4 Evidence from pharmaceutical studies 270
17.5 The role of nitric oxide and endothelin 271
17.6 Conclusions 271
18 The diabetic foot 277
Michael D. Flynn
18.1 Introduction 277
18.2 Pathogenesis: the neuroischaemic and neuropathic foot 277
18.3 The microcirculation of the foot 278
18.4 Regulation of microvascular blood flow 279
18.5 The abnormal circulation in the diabetic foot 280
18.6 Capillary morphological changes in diabetes 281
18.7 Changes in the capillary basement membrane 281
18.8 Is there small vessel disease? 282
18.9 Changes in the capillary endothelium 283
18.10 Functional changes in the microcirculation 284
18.11 Neuropathy and microvascular disease 285
18.12 Capillary flow in the diabetic foot 287
18.13 Do closed capillaries contribute to ischaemia in the skin of the foot? 287
18.14 Clinical implications 288
18.15 Conclusions 289
Index 297
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| isbn | 0340741023 |
| language | English |
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| spelling | Diabetic angiopathy ed. by John E Tooke London [u.a.] Arnold 1999 XVI, 304 S. Ill., graph. Darst. txt rdacontent n rdamedia nc rdacarrier Arterial Occlusive Diseases Diabetic Angiopathies Diabetic angiopathies Tooke, John E. Sonstige oth HBZ Datenaustausch application/pdf http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&local_base=BVB01&doc_number=009119810&sequence=000002&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA Inhaltsverzeichnis |
| spellingShingle | Diabetic angiopathy Arterial Occlusive Diseases Diabetic Angiopathies Diabetic angiopathies |
| title | Diabetic angiopathy |
| title_auth | Diabetic angiopathy |
| title_exact_search | Diabetic angiopathy |
| title_full | Diabetic angiopathy ed. by John E Tooke |
| title_fullStr | Diabetic angiopathy ed. by John E Tooke |
| title_full_unstemmed | Diabetic angiopathy ed. by John E Tooke |
| title_short | Diabetic angiopathy |
| title_sort | diabetic angiopathy |
| topic | Arterial Occlusive Diseases Diabetic Angiopathies Diabetic angiopathies |
| topic_facet | Arterial Occlusive Diseases Diabetic Angiopathies Diabetic angiopathies |
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