From Endothelial Dysfunction to Arterial Stiffness in Diabetes Mellitus

Abstract

Prevalence of diabetes mellitus has increased drastically over time, especially in more populous countries such as the United States, India, and China. Patients with diabetes have an increased risk of major cardiovascular events such as acute myocardial infarction, cerebrovascular disease, and peripheral vascular disease. Arterial stiffness is a process related to aging and vascular, metabolic, cellular and physiological deterioration. In recent years, it has been described as an independent predictor of cardiovascular mortality and coronary artery disease. Additionally, it plays an important role in the measurement of chronic disease progression. Recent studies have suggested a strong relationship between diabetes mellitus and arterial stiffness since they share a similar pathophysiology involving endothelial dysfunction. The literature has shown that microvascular and macrovascular complications in diabetic patients could be screened and measured with arterial stiffness. Additionally, new evidence proposes that there is a relationship between blood glucose levels, microalbuminuria, and arterial stiffness. Moreover, arterial stiffness predicts cardiovascular risk and is independently associated with mortality in diabetic patients. Abnormal arterial stiffness values in diabetic patients should alert the clinician to the presence of vascular disease, which merits early study and treatment. We await more studies to determine if arterial stiffness could be considered a routine useful non-invasive tool in the evaluation of diabetic patients. There is enough evidence to conclude that arterial stiffness is related to the progression of diabetes mellitus.

Association between brachial-ankle pulse wave velocity and risk of type 2 diabetes mellitus: results from a cohort study

“… 25 Endothelial dysfunction is the shared pathophysiology of AS and T2DM, and it has been demonstrated to precede clinically evident T2DM. 26 Second, microvascular rarefaction might directly reduce the uptake of glucose by the skeletal muscle, leading to reduced insulin sensitivity. 27 Third, chronic inflammation might induce structural changes in the arterial wall by breaking down the elastin, affecting the proliferation of smooth muscle cells, and changing the composition of the extracellular matrix, 28 thus facilitating the progression of AS.…”

Diabetic Endothelial Cells Differentiated From Patient iPSCs Show Dysregulated Glycine Homeostasis and Senescence Associated Phenotypes

“…Type 2 diabetes mellitus (T2DM) is characterized by hyperglycemia, insulin resistance, and relative lack of insulin secretion (DeFronzo et al, 2015). T2DM causes endothelial dysfunction, induces abnormal aniogenesis, and changes serum amino acid metabolism, especially for glycine, which is significantly decreased, due to hyperglycemia (Thalacker-Mercer et al, 2014;Drabkova et al, 2015;Giraldo-Grueso and Echeverri, 2020). These factors constitute molecule and cellular basis for both microvascular and macrovascular complications in diabetes (DeFronzo et al, 2015;Palmer A.K.…”

Peripheral endothelial dysfunction in myalgic encephalomyelitis/chronic fatigue syndrome

“…5,6 ED is found in various conditions including diabetes mellitus, arterial hypertension, chronic heart failure, and stroke. 5,[7][8][9] CV symptoms such as autonomic dysregulation, postural hypotension, postural tachycardia syndrome, and reduced cardiac and blood volume have been observed in patients with ME/CFS. 2,10,11 There is growing evidence that ED is frequent in autoimmune disease and is associated with chronic inflammation.…”