糖尿病患者合并心血管疾病诊治专家共识

国家卫生健康委员会能力建设和继续教育中心 孙艺红1 陈康2 陈歆3 谷伟军2 郭远林4 李一君2 刘彤5 彭道泉6 母义明2 马长生5

1 中日友好医院心脏科，北京 100029；2 解放军总医院第一医学中心内分泌科，北京 100853；3 上海交通大学医学院附属瑞金医院高血压科 200025；4 中国医学科学院 北京 协和医学院 阜外医院心血管内科，北京100037；5 首都医科大学附属北京安贞医院心脏 内科中心 国家心血管疾病临床医学研究中心 100029；6 中南大学湘雅二医院心血管内 科，长沙 410011

通信作者：母义明，Email：该Email地址已收到反垃圾邮件插件保护。要显示它您需要在浏览器中启用JavaScript。；马长生，Email：chshma@vip. sina.com

【提要】 糖尿病是心血管疾病最重要的合并疾病，心血管疾病是 2型糖尿病患者致死致残的主要原因。为规范糖尿病合并心血管疾病患者的诊疗，国家卫生健康委员会能力建设和继续教育中心组织心脏科和内分泌科领域的专家，总结国内外相关学科研究进展及专家经验，制定了本共识。本共识分别从心血管疾病和糖尿病管理的角度进行阐述，涵盖糖尿病合并心血管疾病（主要包括动脉粥样硬化性心血管病和心力衰竭）的诊断、药物治疗及危险因素管理等相关的临床重要内容，旨在加强患者的综合管理并最终改善患者预后。心血管疾病的管理主要包括血压、血脂、抗栓、抗心肌缺血、抗心室重构等。糖尿病的管理主要包括生活方式干预、降糖、血糖监测治疗及低血糖预防。此外，本共识还针对特殊人群如糖尿病肾病、高龄（>75岁）及心血管危重症等患者给出了具体的临床建议。

【关键词】 糖尿病； 冠心病； 心力衰竭； 血压； 血脂； 降糖治疗、

Expert consensus on the management of diabetic patients with cardiovascular diseases

National Health Commissim Capacity Buiding and Continuing Education Center, Sun Yihong1 ,Chen Kang2 , Chen Xin3 , Gu Weijun2 , Guo Yuanlin4 , Li Yijun2 , Liu Tong5 , Peng Daoquan6 , Mu Yiming2 ,Ma Changsheng5 

1Department of Cardiology, China‑Japan Friendship Hospital, Beijing 100029, China; 2 Department ofEndocrinology, The First Medical Center of Chinese PLA General Hospital, Beijing 100853, China;3Department of Hypertension, Ruijin Hospital, Shanghai Jiaotong University School of Medicine,Shanghai 200025, China; 4 Department of Cardiology, Fuwai Hospital, Peking Union Medical College,Chinese Academy of Medical Sciences, Beijing 100037, China; 5 Department of Cardiology, BeijingAnzhen Hospital, Capital Medical University, National Center for Cardiovascular Diseases, Beijing100029, China; 6Department of Cardiology, the Second Xiangya Hospital of Central South University,Changsha 410011, China

[Summary]Diabetes is the most important comorbidity of cardiovascular disease, andcardiovascular disease is the main cause of mortality and disability of patients with type 2 diabetes.In order to standardize the diagnosis and treatment of patients with diabetes and cardiovasculardisease, the National Health Commission Capacity Building and Continuing Education Centerorganized the experts from the field of cardiology and endocrinology systematically reviewing theresearch progresses and expert experiences of relevant disciplines from home and abroad, and formulated this consensus. This consensus covers the diagnosis, drug treatment, and risk factor management for patients with diabetes and cardiovascular disease (including atherosclerotic cardiovascular disease and heart failure) from the perspective of cardiovascular disease and diabetes management aiming to strengthen the comprehensive management of patients and ultimately to improve the prognosis of patients. The management of cardiovascular diseases mainly includes the management of blood pressure, blood lipids, anti‑thrombosis, anti‑myocardial ischemia, anti‑ventricular remodeling and so on. Diabetes management mainly includes lifestyle intervention (including diet, exercise, weight loss, etc.), anti‑hyperglycemia therapy (including drugs and insulin), blood glucose monitoring, and hypoglycemic prevention. In addition, specific clinical recommendations are given to patients with special health care needs such as diabetic nephropathy, elderly (>75 years), and cardiovascular critical illness.

【Key words】 Diabetes mellitus; Coronary heart disease; Heart failure; Blood pressure; Blood lipid; Anti‑hyperglycemic treatment

中国黄褐斑诊疗专家共识（2021版）

中国中西医结合学会皮肤性病专业委员会色素病学组 中华医学会皮肤性病学分会白癜风研究中心 中国医师协会皮肤科医师分会色素病工作组

通信作者：何黎，Email：该Email地址已收到反垃圾邮件插件保护。要显示它您需要在浏览器中启用JavaScript。；许爱娥，Email：该Email地址已收到反垃圾邮件插件保护。要显示它您需要在浏览器中启用JavaScript。

【摘要】 目前认为黄褐斑的发病与遗传、日光、性激素等有关，涉及黑素合成增加、皮损处血管增生、炎症反应及皮肤屏障受损等机制。诊断主要依据临床表现和无创检测技术。该指南结合近年研究新进展，全面阐述了黄褐斑的病因及发病机制、临床表现、分期与分型、诊断及治疗等，旨在提高中国皮肤科医师对黄褐斑的诊治水平。

【关键词】 黄褐斑；指南；诊断；治疗

DOI：10.35541/cjd.20200900

Consensus on diagnosis and treatment of melasma in China（2021 version）

Pigmentary Disorder Group, Combination of Traditional and Western Medicine Dermatology; Research Center for Vitiligo, Chinese Society of Dermatology; Working Group on Pigmentary Disorders, China Dermatologist Association

Corresponding authors: He Li, Email: 该Email地址已收到反垃圾邮件插件保护。要显示它您需要在浏览器中启用JavaScript。; Xu Ai′e, Email: 该Email地址已收到反垃圾邮件插件保护。要显示它您需要在浏览器中启用JavaScript。

【Abstract】 At present, exact pathogenesis of melasma remains unclear, genetics, sunlight exposure, sex hormones, etc., are considered as the main causative factors. Its pathogenesis involves excessive melanin synthesis, vascular hyperplasia in skin lesions, inflammation and skin barrier impairment. The diagnosis of melasma mainly relies on clinical manifestations and non⁃invasive detection techniques. Based on research progress in recent years, this consensus comprehensively elaborates the etiology, pathogenesis, clinical manifestations, staging and classification, diagnosis and treatment of melasma, aiming to improve the diagnosis and treatment of melasma by Chinese dermatologists.

【Key words】 Melasma; Guidelines; Diagnosis; Therapy DOI: 10.35541/cjd.20200900

Life-threatening risk factors contribute to the development of diseases with the highest mortality through the induction of regulated necrotic cell death

Zsuzsa Muszka 1,2,4 , Viktória Jenei1,3,4, Rebeka Mácsik1 , Evgeniya Mezhonova1 , Silina Diyab1 , Réka Csősz1 , Attila Bácsi1 , Anett Mázló1✉ and Gábor Koncz 1 ✉

Chronic diseases affecting the cardiovascular system, diabetes mellitus, neurodegenerative diseases, and various other organspecific conditions, involve different underlying pathological processes. However, they share common risk factors that contribute to the development and progression of these diseases, including air pollution, hypertension, obesity, high cholesterol levels, smoking and alcoholism. In this review, we aim to explore the connection between four types of diseases with different etiologies and various risk factors. We highlight that the presence of risk factors induces regulated necrotic cell death, leading to the release of damage-associated molecular patterns (DAMPs), ultimately resulting in sterile inflammation. Therefore, DAMP-mediated inflammation may be the link explaining how risk factors can lead to the development and maintenance of chronic diseases. To explore these processes, we summarize the main cell death pathways activated by the most common life-threatening risk factors, the types of released DAMPs and how these events are associated with the pathophysiology of diseases with the highest mortality.

Cell Death and Disease (2025) 16:273 ; https://doi.org/10.1038/s41419-025-07563-7

FACTS

Environmental, physiological or behavioral risk factors can induce regulated necrotic cell death and DAMP production.

DAMP-related sterile inflammation plays a role in the development and progression of cardiovascular diseases, neurodegenerative diseases, diabetes or alcoholic and non-alcoholic liver diseases.

Current anti-inflammatory treatments do not target the root cause of cell death processes and the release of DAMPs.

OPEN QUESTIONS

To what extent can the harmful effects of risk factors be mitigated by regulating necrotic cell death?

To what extent do the DAMP patterns of pathologies associated with sterile inflammation overlap?

In which diseases can drugs targeting the pathomechanism ofsterile inflammation be used, such as drugs that inhibit the effects of regulated cell death or DAMPs?

1 Department of Immunology, Faculty of Medicine, University of Debrecen, Egyetem square 1, 4032 Debrecen, Hungary. 2 Doctoral School of Molecular Cell and Immune Biology, University of Debrecen, Egyetem square 1, 4032 Debrecen, Hungary. 3 Gyula Petrányi Doctoral School of Allergy and Clinical Immunology, University of Debrecen, Egyetem square 1, 4032 Debrecen, Hungary. 4 These authors contributed equally: Zsuzsa Muszka, Viktória Jenei. ✉email: 该Email地址已收到反垃圾邮件插件保护。要显示它您需要在浏览器中启用JavaScript。; 该Email地址已收到反垃圾邮件插件保护。要显示它您需要在浏览器中启用JavaScript。 Edited By Massimiliano Agostini

Beyond the genome: protecting the proteome may be the key to preventing skin aging

Brigitte DRÉNO1 Isabelle BENOIT2 Eric PERRIER2 Miroslav RADMAN3

1 INSERM, CNRS, Immunology and New Concepts in ImmunoTherapy, INCIT, UMR 1302/EMR6001, Nantes Université, Nantes, France

2 NAOS-ILS, Aix-en-Provence, France,

3 Mediterranean Institute for Life Sciences, Split, Croatia, Naos Institute for Life Sciences, Aix-en-Provence, France, Université R.-Descartes Paris-5, Faculté de Médecine, INSERM U1, Paris, France

Reprints: Brigitte Dréno<该Email地址已收到反垃圾邮件插件保护。要显示它您需要在浏览器中启用JavaScript。> <该Email地址已收到反垃圾邮件插件保护。要显示它您需要在浏览器中启用JavaScript。>

Isabelle Benoit <该Email地址已收到反垃圾邮件插件保护。要显示它您需要在浏览器中启用JavaScript。>

Eric Perrier <该Email地址已收到反垃圾邮件插件保护。要显示它您需要在浏览器中启用JavaScript。>

Skin aging is associated with a progressive decline in physiological functions, skin cancers and, ultimately, death. It may be categorized as intrinsic or extrinsic, whereby intrinsic aging is attributed to chrono-logical and genetic factors. At the molecular level, skin aging involves changes in protein conformation and function. The skin proteome changes constantly, mainly through carbonylation; an irreversible phenomenon leading to protein accumulation as toxic aggregates that impair cellular physiology and accelerate skin aging. This review details the central role of proteostasis during skin aging and why proteome protection may be a promising approach in mitigating skin aging. A comprehensive literature review of 87 articles focusing on the proteome, proteostasis, proteotoxicity, protein carbonylation, and the impact of the damaged proteome on aging, and in particular skin aging, was conducted. Skin aging is associated with deficiencies in the repair mechanisms of DNA, transcriptional control, mitochondrial function, cell cycle control, apoptosis, cellular metabolism, changes in hormonal levels secondary to toxicity of damaged proteins, and cell-to-cell communication for tissue homeostasis, which are largely controlled by proteins. In this context, a damaged proteome that leads to the loss of proteostasis may be considered as the first step in tissue aging. There is growing evidence that a healthy proteome plays a central role in skin and in maintaining healthy tissues, thus slow-ing down the process of skin aging. Hence, protecting the proteome against oxidative or other damage may be an appropriate strategy to prevent and delay skin aging.

Keywords: proteome, proteostasis, protein carbonylation, skin aging

Spatially and cell-type resolved quantitative proteomic atlas of healthy human skin

Beatrice Dyring-Andersen1,2,3,4, Marianne Bengtson Løvendorf5, Fabian Coscia1 , Alberto Santos1 , Line Bruun Pilgaard Møller1 , Ana R. Colaço1 , Lili Niu1 , Michael Bzorek6, Sophia Doll7, Jørgen Lock Andersen8, Rachael A. Clark2, Lone Skov 4, Marcel B. M. Teunissen 9 & Matthias Mann 1,7✉

Human skin provides both physical integrity and immunological protection from the external environment using functionally distinct layers, cell types and extracellular matrix. Despite its central role in human health and disease, the constituent proteins of skin have not been systematically characterized. Here, we combine advanced tissue dissection methods, flow cytometry and state-of-the-art proteomics to describe a spatially-resolved quantitative pro-teomic atlas of human skin. We quantify 10,701 proteins as a function of their spatial location and cellular origin. The resulting protein atlas and our initial data analyses demonstrate the value of proteomics for understanding cell-type diversity within the skin. We describe the quantitative distribution of structural proteins, known and previously undescribed proteins specific to cellular subsets and those with specialized immunological functions such as cytokines and chemokines. We anticipate that this proteomic atlas of human skin will become an essential community resource for basic and translational research (https://skin.science/).

1Novo Nordisk Foundation (NNF) Center for Protein Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark. 2Department of Dermatology, Brigham and Women’s Hospital and Harvard Medical School, Boston, USA. 3 Leo Foundation Skin Immunology Research Center, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark. 4Department of Dermatology and Allergology, Herlev and Gentofte Hospital, University of Copenhagen, Hellerup, Denmark. 5 Center for RNA Medicine, Department of Clinical Medicine, Aalborg University, Copenhagen, Denmark. 6Department of Surgical Pathology, Zealand University Hospital, Næstved, Denmark. 7Department of Proteomics and Signal Transduction, Max Planck Institute of Biochemistry, Martinsried, Germany. 8Department of Plastic and Breast Surgery, Zealand University Hospital, Roskilde, Denmark. 9Department of Dermatology, Amsterdam University Medical Centers, location AMC, Amsterdam, Netherlands. ✉email: 该Email地址已收到反垃圾邮件插件保护。要显示它您需要在浏览器中启用JavaScript。

Quantitative proteomics analysis of young and elderly skin with DIA mass spectrometry reveals new skin aging-related proteins

Jing Ma1,2, Mengting Liu1,2, Yaochi Wang1,2, Cong Xin1,2, Hui Zhang1,2, Shirui Chen1,2, Xiaodong Zheng1,2, Xuejun Zhang1,2, Fengli Xiao1,2,3 , Sen Yang1,2

1Department of Dermatology of First Affiliated Hospital, and Institute of Dermatology, Anhui Medical University, Hefei, Anhui, China

2 Key Laboratory of Dermatology, Anhui Medical University, Ministry of Education, Hefei, Anhui, China

3 The Center for Scientific Research of Anhui Medical University, Hefei, Anhui, China

Correspondence to: Sen Yang, Fengli Xiao;

email: 该Email地址已收到反垃圾邮件插件保护。要显示它您需要在浏览器中启用JavaScript。, 该Email地址已收到反垃圾邮件插件保护。要显示它您需要在浏览器中启用JavaScript。

Keywords: aging, epidermal proteins, skin rejuvenation and aging, proteome, mass spectrometer

Received: February 25, 2020

Accepted: May 27, 2020

Published:

Copyright: Ma et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY 3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

ABSTRACT

Skin aging is a specific manifestation of the physiological aging process that occurs in virtually all organisms In this study, we used data independent acquisition mass spectrometry to perform a comparative analysis of protein expression in volar forearm skin samples from of 20 healthy young and elderly Chinese individuals. Our quantitative proteomic analysis identified a total of 95 differentially expressed proteins (DEPs) in aged skin compared to young skin. Enrichment analyses of these DEPs (57 upregulated and 38 downregulated proteins) based on the GO, KEGG, and KOG databases revealed functional clusters associated with immunity and inflammation, oxidative stress, biosynthesis and metabolism, proteases, cell proliferation, cell differentiation, and apoptosis. We also found that GAPDH, which was downregulated in aged skin samples, was the top hub gene in a protein-protein interaction network analysis. Some of the DEPs identified herein had been previously correlated with aging of the skin and other organs, while others may represent novel age-related entities. Our non-invasive proteomics analysis of human epidermal proteins may guide future research on skin aging to help develop treatments for age-related skin conditions and rejuvenation.