VASCULAR REACTIVITY IN METABOLIC SYNDROME AND DIABETIC PATIENTS

代谢综合征和糖尿病患者的血管反应性

基本信息

批准号：
8362670
负责人：
ALBERT Edward CERUSSI
金额：
$ 0.51万
依托单位：
UNIVERSITY OF CALIFORNIA-IRVINE
依托单位国家：
美国
项目类别：
财政年份：
2011
资助国家：
美国
起止时间：
2011-04-01 至 2012-03-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8362670
关键词：
Ambulatory Care Facilities Biotechnology Blood Circulation Blood Glucose Blood Vessels Blood capillaries Blood flow Cardiovascular Diseases Caring Clinic Clinical Collaborations Defect Development Diabetes Mellitus Diagnosis Diffuse Disease Disease Progression Early Diagnosis Exposure to Funding Glucose Intolerance Grant Hemoglobin Institutes Insulin Resistance Lasers Lead Life Light Lipids Measures Metabolic Metabolic stress Metabolic syndrome Monitor Muscle National Center for Research Resources Nerve Neuropathy Optics Oxyhemoglobin Patient Monitoring Patients Perfusion Peripheral Nervous System Diseases Permeability Principal Investigator Property Protocols documentation Research Research Infrastructure Research Project Grants Resources Risk Screening procedure Source Spectrum Analysis Structure Techniques Time Tissues United States National Institutes of Health Water absorption capillary cardiovascular disorder risk cardiovascular risk factor cost deoxyhemoglobin diabetic diabetic patient malignant breast neoplasm new technology response tool

项目摘要

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. Primary support for the subproject and the subproject's principal investigator may have been provided by other sources, including other NIH sources. The Total Cost listed for the subproject likely represents the estimated amount of Center infrastructure utilized by the subproject, not direct funding provided by the NCRR grant to the subproject or subproject staff. Metabolic Syndrome is a highly prevalent condition that is comprised of several major clustering factors that increase the risk for developing cardiovascular disease (CVD). [41-43] The hallmarks of Metabolic Syndrome are discussed later in the protocol, however, insulin resistance, glucose intolerance, and/or Diabetes Mellitus (DM) are contributing factors to a diagnosis of Metabolic Syndrome. However, if the patient has DM alone, then he/she is still at risk for developing CVD, as insulin resistance on its own is associated with vascular changes. [38, 39] These disturbances can be seen down to the level of the microvasculature. Further, these vascular disturbances also lead to nerve damage and neuropathy. Diabetic Peripheral Neuropathy (DPN) is a condition brought on by prolonged exposure to high blood glucose. Interestingly, neuropathy can also modulate vascular reactivity and hence alter circulation. [44] Thus, it is important to monitor microvascular changes in patients to assess their disease progression and cardiovascular risks. Microvascular disturbances include abnormalities in arteriolar reactivity, capillary recruitment, permeability, and blood flow. [45] These changes are evident in both Metabolic Syndrome and DM patients. There are varying degrees of these disruptions, and the defects in small vessel structure and function can be observed very early in life and early in disease. [45] Therefore screening for microvascular changes in patients predisposed to the development of DM, Metabolic Syndrome, or CVD should provide a means to evaluate both progression towards a given disease state as well as the advancement of that disease. Thus, studying microvascular changes in patients may be of clinical importance in diseased patients as well as at-risk patients; however, there are no established, non-invasive, accurate, and easy ways to measure these changes at clinics. A tool that would allow clinicians to non-invasively measure changes in the microvasculature (for example, by quantifying the change in concentrations of deoxyhemoglobin and oxyhemoglobin in the microvasculature in response to metabolic stress) in an outpatient clinic, could allow for earlier detection and long-term monitoring of patients. This would allow more time for preventative care and treatment. This research project, in collaboration with partners at the Beckman Laser Institute, aims to evaluate the hypothesis that a novel technology known as Diffuse Optical Spectroscopy (DOS) can be used to non-invasively measure changes in the microvasculature of patients. DOS is a technique that measures the optical absorption and scattering properties of near-infrared light in tissues such as muscle in order to quantify the absolute concentration of oxygenated and deoxygenated hemoglobin, water, and lipids. It provides quantitative and functional information on the microvasculature related to tissue perfusion, metabolic changes, and indicators of tissue damage. It has shown promise in the field of breast cancer, and we seek to evaluate the potential of DOS as a means to measure microvascular changes in Metabolic Syndrome and DM patients in order to assess CVD risk.

该子项目是利用资源的众多研究子项目之一由 NIH/NCRR 资助的中心拨款提供。子项目的主要支持并且子项目的首席研究员可能是由其他来源提供的，包括其他 NIH 来源。子项目可能列出的总成本代表子项目使用的中心基础设施的估计数量， NCRR 赠款不直接向子项目或子项目工作人员提供资金。代谢综合症是一种非常普遍的疾病，由几个主要的聚集因素组成，这些因素会增加患心血管疾病 (CVD) 的风险。 [41-43] 代谢综合征的标志将在方案后面讨论，然而，胰岛素抵抗、葡萄糖不耐受和/或糖尿病 (DM) 是代谢综合征诊断的影响因素。然而，如果如果患者仅患有糖尿病，那么他/她仍然有患心血管疾病的风险，因为胰岛素抵抗本身与血管变化有关。 [38, 39] 这些干扰可以追溯到微脉管系统的水平。此外，这些血管紊乱还会导致神经损伤和神经病。糖尿病周围神经病变（DPN）是一种因长期接触高血糖而引起的疾病。有趣的是，神经病变也可以调节血管反应性，从而改变循环。 [44]因此，监测患者的微血管变化以评估他们的疾病进展和治疗非常重要。心血管风险。微血管紊乱包括小动脉反应性、毛细血管募集、渗透性和血流异常。 [45] 这些变化在代谢综合征和糖尿病患者中都很明显。这些破坏程度不同，小血管结构和结构也存在缺陷。功能可以在生命早期和疾病早期观察到。 [45] 因此，对易患糖尿病、代谢综合征或心血管疾病的患者进行微血管变化筛查，应提供一种方法来评估特定疾病状态的进展以及该疾病状态的进展。疾病。因此，研究患者的微血管变化对于患病患者以及高危患者可能具有临床重要性。然而，目前还没有既定的、非侵入性的、准确且简单的方法来在诊所测量这些变化。一种允许临床医生在门诊以非侵入性方式测量微脉管系统变化的工具（例如，通过量化微脉管系统中脱氧血红蛋白和氧合血红蛋白浓度因代谢应激而发生的变化），可以实现早期检测和长期监测。对患者进行长期监测。这将为预防工作留出更多时间护理和治疗。该研究项目与贝克曼激光研究所的合作伙伴合作，旨在评估一种假设，即一种称为漫反射光谱 (DOS) 的新技术可用于非侵入性测量患者微血管的变化。 DOS 是一种测量技术近红外光在肌肉等组织中的光学吸收和散射特性，以量化含氧和脱氧血红蛋白、水和脂质的绝对浓度。它提供与组织灌注、代谢变化和组织损伤指标相关的微脉管系统的定量和功能信息。它在乳腺癌领域显示出了前景，我们寻求评估 DOS 作为测量代谢综合征和糖尿病患者微血管变化的手段的潜力，以评估 CVD 风险。