DISFUNÇAO ENDOTELIAL E MICROALBUMINURIA EM DIABETES MELLITUS TIPO 1





DISFUNÇAO ENDOTELIAL E MICROALBUMINURIA EM DIABETES MELLITUS TIPO 1

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A estreita correlação entre aumento da excreção de albumina, mesmo em fase inicial (microalbuminúria) e disfunção endotelial fortalece a importância da microalbuminúria como marcador precoce de aterotrombose, também em pacientes jovens e com curta duração de doença.
Autor:
Ana marice Ladeia
Columnista Experto de SIIC
Artículos publicados por Ana marice Ladeia
Coautor
Luís Adan* 
Professor Adjunto, Bahía, Brasil*
Recepción del artículo
1 de Noviembre, 2006
Aprobación
23 de Febrero, 2007
Primera edición
9 de Abril, 2007
Segunda edición, ampliada y corregida
7 de Junio, 2021

Resumen
A importância do endotélio no corpo humano está relacionado à sua extensão e suas múltiplas funções biológicas. A disfunção endotelial é a manifestação mais precoce da patologia vascular, decorrendo do desequilíbrio entre os fatores de relaxamento e os de contração, entre mediadores anti e pró-coagulantes ou de fatores de promoção e inibição do crescimento de células musculares lisas. Fatores de risco como dislipidemia, tabagismo e diabetes desencadeiam o processo aterosclerótico inicialmente pela simples ativação endotelial, posteriormente pela sua disfunção. Estudos têm sido desenvolvidos visando a compreender o papel da hiperglicemia e da duração do diabetes na patogênese da disfunção endotelial. Microalbuminúria é um marcador precoce de nefropatia em diabetes, cuja associação com disfunção endotelial em diabetes tipo 1 tem sido demonstrada em vários estudos. Mecanismos que expliquem essa associação sido sugeridos; entre eles, inflamação sub-clínica, aumento da pressão glomerular ou enfraquecimento da sua membrana basal e lesão do glicocálice endotelial. O melhor entendimento desses mecanismos poderá abrir perspectivas terapêuticas que visem a minimizar, ou interromper a agressão vascular na sua fase mais precoce e assim prevenir o aparecimento de complicações vasculares. Nesta revisão são discutidas evidências relacionadas ao papel da disfunção endotelial como marcador precoce de complicações vasculares em diabetes tipo 1.

Palabras clave
disfunção endotelial, microalbuminúria, diabetes tipo 1, aterosclerose, crianças


Artículo completo

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Abstract
The importance of the endothelium to the human body is related to its extent and multiple biological functions. Endothelial dysfunction is the earliest manifestation of vascular pathology, resulting from imbalance between relaxation and contraction, and anti- and pro-coagulant mediators or factors that promote and inhibit the growth of smooth muscle cells. Risk factors such as, dyslipidemia, smoking and diabetes lead to the onset of the aterosclerotic process, initially simply by endothelial activation and later by its dysfunction. Studies have been designed with the aim of understanding the role of hyperglycemia and the duration of diabetes in the pathogenesis of endothelial dysfunction. Microalbuminuria is an early marker of nephropathy in diabetes, whose association with endothelial dysfunction in Type 1 diabetes has been shown in various studies. Mechanisms that explain this association have been suggested. Among them we can mention: sub-clinical inflammation, increase in glomerular pressure or weakening of its basal membrane and lesion of the endothelial glycocalyx. Better understanding of these mechanisms may bring about therapeutic perspectives that aim to minimize, or interrupt vascular aggression in its earliest stage, and thus prevent the appearance of vascular complications. In this review, the evidences related to the role of endothelial dysfunction as early marker of vascular complications in Type 1 diabetes are discussed.

Key words
endothelial dysfunction, microalbuminuria, type 1 diabetes tmellitus, atherosclerosis, children


Clasificación en siicsalud
Artículos originales > Expertos de Iberoamérica >
página   www.siicsalud.com/des/expertocompleto.php/

Especialidades
Principal: Cardiología
Relacionadas: Diagnóstico por Laboratorio, Medicina Interna, Nefrología y Medio Interno



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Enviar correspondencia a:
Ana Marice Ladeia, Escola Bahiana de Medicina e Saúde Pública, 41810-570, Rua Altino Seberto de Barros 241 sala 506 - Itaigara, Salvador, Brasil
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