The mystery of diabetes and atherosclerosis: time for a new plot

CF Semenkovich, JW Heinecke - Diabetes, 1997 - Am Diabetes Assoc
CF Semenkovich, JW Heinecke
Diabetes, 1997Am Diabetes Assoc
Most patients with diabetes die from macrovascular complications. Little is known about the
pathogenesis of diabetic vascular disease, but recent advances in molecular genetics and
oxidation chemistry provide clues to the mystery of diabetes and atherosclerosis. Genetic
variants of well-known proteins such as lipoprotein lipase and apolipoprotein E are
common. These proteins are suitable candidates for mediating diabetic vascular risk
because their variants can produce hypertriglyceridemia, a risk factor for atherosclerosis in …
Most patients with diabetes die from macrovascular complications. Little is known about the pathogenesis of diabetic vascular disease, but recent advances in molecular genetics and oxidation chemistry provide clues to the mystery of diabetes and atherosclerosis. Genetic variants of well-known proteins such as lipoprotein lipase and apolipoprotein E are common. These proteins are suitable candidates for mediating diabetic vascular risk because their variants can produce hypertriglyceridemia, a risk factor for atherosclerosis in diabetes. However, mutations could have different effects on lipoprotein flux across arteries depending on whether expression is dominant in the vascular space or the vascular wall. Lipoproteins retained in the arterial wall are subject to oxidative modification, which could be dependent on glycoxidation, the enzyme myeloperoxidase, or reactive nitrogen species derived from nitric oxide. Accelerated vascular disease in diabetes is likely the result of complex interactions between metabolic derangements such as hyperglycemia, mutations in genes controlling lipid metabolism, and antioxidant defense mechanisms.
Am Diabetes Assoc