Endothelial function and the microcirculation in diabetes mellitus

摘要: The role of endothelial dysfunction in the pathogenesis diabetic microangiopathy is reviewed. Reversible alterations microcirculation, consisting increased capillary pressure, blood flow and permeability, can be detected at an early stage diabetes mellitus. Irreversible structural modifications vascular wall, such as thickening basal membrane due to extracellular accumulation proteins, take place later stages. Atherosclerosis further affects microcirculation mellitus by decreasing autoregulatory capacity reserve. Endothelial has been observed precede onset microvascular lesions, demonstrated reduction vasodilatory response vasoactive agents antithrombotic properties endothelium. Experimental data available so far suggest that may directly related hyperglycemia. Abnormalities lipoprotein metabolism, generation glycation end products, oxidative stress also responsible for Insulin resistance appears non-insulin-dependent through a biological activity endothelial-derived nitric oxide.