Chronic, low-grade systemic inflammation and impaired microvascular function are critical hallmarks in the development of insulin resistance. Accordingly, insulin resistance is a major risk factor for type 2 diabetes and cardiovascular disease. Accumulating studies demonstrate that restoration of impaired function of the diabetic macro- and microvasculature may ameliorate a range of cardiovascular disease states and diabetes-associated complications. In this review, we focus on the emerging role of microRNAs (miRNAs), noncoding RNAs that fine-tune target gene expression and signaling pathways, in insulin-responsive tissues and cell types important for maintaining optimal vascular homeostasis and preventing the sequelae of diabetes-induced end organ injury. We highlight current pathophysiological paradigms of miRNAs and their targets involved in regulating the diabetic microvasculature in a range of diabetes-associated complications such as retinopathy, nephropathy, wound healing, and myocardial injury. We provide an update of the potential use of circulating miRNAs diagnostically in type I or type II diabetes. Finally, we discuss emerging delivery platforms for manipulating miRNA expression or function as the next frontier in therapeutic intervention to improve diabetes-associated microvascular dysfunction and its attendant clinical consequences.

中文翻译：

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MicroRNA在糖尿病微血管疾病中的新兴作用：治疗的新目标。

慢性，低度全身性炎症和微血管功能受损是胰岛素抵抗发展的关键标志。因此，胰岛素抵抗是2型糖尿病和心血管疾病的主要危险因素。越来越多的研究表明，糖尿病大血管和微血管功能受损的恢复可能会改善一系列心血管疾病和与糖尿病相关的并发症。在这篇综述中，我们重点关注微RNA（miRNA），微调靶基因表达和信号传导途径的非编码RNA在胰岛素反应性组织和细胞类型中的作用，这些作用对于维持最佳的血管稳态和预防糖尿病后遗症至关重要-引起终末器官损伤。我们重点介绍了miRNA的当前病理生理范例及其在调节与糖尿病相关的一系列并发症（如视网膜病变，肾病，伤口愈合和心肌损伤）中调控糖尿病微脉管系统的靶标。我们提供了诊断I型或II型糖尿病中循环miRNA潜在用途的更新。最后，我们讨论了操纵miRNA表达或作为治疗性干预中改善糖尿病相关微血管功能障碍及其伴随的临床后果的下一个前沿领域的新兴递送平台。我们提供了诊断I型或II型糖尿病中循环miRNA潜在用途的更新。最后，我们讨论了操纵miRNA表达或作为治疗性干预中改善糖尿病相关微血管功能障碍及其伴随的临床后果的下一个前沿领域的新兴递送平台。我们提供了诊断I型或II型糖尿病中循环miRNA潜在用途的更新。最后，我们讨论了操纵miRNA表达或作为治疗性干预中改善糖尿病相关微血管功能障碍及其伴随的临床后果的下一个前沿领域的新兴递送平台。