The Distinctive Nature of Atherosclerotic Vascular Disease in Diabetes: Pathophysiological and Morphological Insights | springermedicine.com

Springer Medicine

Top

Current Diabetes Reports

Published in:

01-06-2012 | Management of Macrovascular Disease in Diabetes (S Inzucchi and R Goldberg, Section Editors)

The Distinctive Nature of Atherosclerotic Vascular Disease in Diabetes: Pathophysiological and Morphological Insights

Authors: Rishi Puri, Yu Kataoka, Kiyoko Uno, Stephen J. Nicholls

Published in: Current Diabetes Reports | Issue 3/2012

Login to get access

Abstract

As the incidence of diabetes mellitus continues to rise, parallel increases in the rates of diabetic atherosclerotic vascular disease are projected to impart major health and socioeconomic challenges for authorities worldwide. Diabetes results in a proatherogenic phenotype, manifesting in an accelerated, diffuse, polyvascular fashion. In this review, we highlight the pathophysiological and morphological hallmarks of diabetic atherosclerosis.

1.

Bandyopadhyay P. Cardiovascular diseases and diabetes mellitus. Drug News Perspect. 2006;19:369–75.PubMed

2.

Caro JJ, Ward AJ, O'Brien JA. Lifetime costs of complications resulting from type 2 diabetes in the U.S. Diabetes Care. 2002;25:476–81.PubMedCrossRef

3.

Nandish S, Wyatt J, Bailon O, Smith M, Oliveros R, Chilton R. Implementing cardiovascular risk reduction in patients with cardiovascular disease and diabetes mellitus. Am J Cardiol. 2011;108:42B–51B.PubMedCrossRef

4.

Hayden MR, Tyagi SC. Vasa vasorum in plaque angiogenesis, metabolic syndrome, type 2 diabetes mellitus, and atheroscleropathy: a malignant transformation. Cardiovasc Diabetol. 2004;3:1.PubMedCrossRef

5.

Ross R, Glomset JA. Atherosclerosis and the arterial smooth muscle cell: Proliferation of smooth muscle is a key event in the genesis of the lesions of atherosclerosis. Science. 1973;180:1332–9.PubMedCrossRef

6.

Witztum JL. The oxidation hypothesis of atherosclerosis. Lancet. 1994;344:793–5.PubMedCrossRef

7.

Ross R. Atherosclerosis–an inflammatory disease. N Engl J Med. 1999;340:115–26.PubMedCrossRef

8.

Galis ZS, Khatri JJ. Matrix metalloproteinases in vascular remodeling and atherogenesis: the good, the bad, and the ugly. Circ Res. 2002;90:251–62.PubMed

9.

Kolodgie FD, Gold HK, Burke AP, et al. Intraplaque hemorrhage and progression of coronary atheroma. N Engl J Med. 2003;349:2316–25.PubMedCrossRef

10.

Glagov S, Weisenberg E, Zarins CK, Stankunavicius R, Kolettis GJ. Compensatory enlargement of human atherosclerotic coronary arteries. N Engl J Med. 1987;316:1371–5.PubMedCrossRef

11.

Libby P. Current concepts of the pathogenesis of the acute coronary syndromes. Circulation. 2001;104:365–72.PubMed

12.

Celermajer DS. Endothelial dysfunction: does it matter? Is it reversible? J Am Coll Cardiol. 1997;30:325–33.PubMedCrossRef

13.

Creager MA, Luscher TF, Cosentino F, Beckman JA. Diabetes and vascular disease: pathophysiology, clinical consequences, and medical therapy: Part I. Circulation. 2003;108:1527–32.PubMedCrossRef

14.

Beckman JA, Goldfine AB, Gordon MB, Creager MA. Ascorbate restores endothelium-dependent vasodilation impaired by acute hyperglycemia in humans. Circulation. 2001;103:1618–23.PubMed

15.

Nishikawa T, Edelstein D, Du XL, et al. Normalizing mitochondrial superoxide production blocks three pathways of hyperglycaemic damage. Nature. 2000;404:787–90.PubMedCrossRef

16.

Laursen JB, Somers M, Kurz S, et al. Endothelial regulation of vasomotion in apoE-deficient mice: implications for interactions between peroxynitrite and tetrahydrobiopterin. Circulation. 2001;103:1282–8.PubMed

17.

Lin KY, Ito A, Asagami T, et al. Impaired nitric oxide synthase pathway in diabetes mellitus: role of asymmetric dimethylarginine and dimethylarginine dimethylaminohydrolase. Circulation. 2002;106:987–92.PubMedCrossRef

18.

Timimi FK, Ting HH, Haley EA, Roddy MA, Ganz P, Creager MA. Vitamin C improves endothelium-dependent vasodilation in patients with insulin-dependent diabetes mellitus. J Am Coll Cardiol. 1998;31:552–7.PubMedCrossRef

19.

Ting HH, Timimi FK, Boles KS, Creager SJ, Ganz P, Creager MA. Vitamin C improves endothelium-dependent vasodilation in patients with non-insulin-dependent diabetes mellitus. J Clin Invest. 1996;97:22–8.PubMedCrossRef

20.

Kuboki K, Jiang ZY, Takahara N, et al. Regulation of endothelial constitutive nitric oxide synthase gene expression in endothelial cells and in vivo: a specific vascular action of insulin. Circulation. 2000;101:676–81.PubMed

21.

Zeng G, Nystrom FH, Ravichandran LV, et al. Roles for insulin receptor, PI3-kinase, and Akt in insulin-signaling pathways related to production of nitric oxide in human vascular endothelial cells. Circulation. 2000;101:1539–45.PubMed

22.

Laakso M, Edelman SV, Brechtel G, Baron AD. Decreased effect of insulin to stimulate skeletal muscle blood flow in obese man. A novel mechanism for insulin resistance. J Clin Invest. 1990;85:1844–52.PubMedCrossRef

23.

Dresner A, Laurent D, Marcucci M, et al. Effects of free fatty acids on glucose transport and IRS-1-associated phosphatidylinositol 3-kinase activity. J Clin Invest. 1999;103:253–9.PubMedCrossRef

24.

Oliver FJ, de la Rubia G, Feener EP, et al. Stimulation of endothelin-1 gene expression by insulin in endothelial cells. J Biol Chem. 1991;266:23251–6.PubMed

25.

Ferri C, Pittoni V, Piccoli A, et al. Insulin stimulates endothelin-1 secretion from human endothelial cells and modulates its circulating levels in vivo. J Clin Endocrinol Metab. 1995;80:829–35.PubMedCrossRef

26.

Kelley DE, Simoneau JA. Impaired free fatty acid utilization by skeletal muscle in non-insulin-dependent diabetes mellitus. J Clin Invest. 1994;94:2349–56.PubMedCrossRef

27.

Inoguchi T, Li P, Umeda F, et al. High glucose level and free fatty acid stimulate reactive oxygen species production through protein kinase C–dependent activation of NAD(P)H oxidase in cultured vascular cells. Diabetes. 2000;49:1939–45.PubMedCrossRef

28.

Steinberg HO, Tarshoby M, Monestel R, et al. Elevated circulating free fatty acid levels impair endothelium-dependent vasodilation. J Clin Invest. 1997;100:1230–9.PubMedCrossRef

29.

Cummings MH, Watts GF, Umpleby AM, et al. Increased hepatic secretion of very-low-density lipoprotein apolipoprotein B-100 in NIDDM. Diabetologia. 1995;38:959–67.PubMedCrossRef

30.

Dimitriadis E, Griffin M, Owens D, Johnson A, Collins P, Tomkin GH. Oxidation of low-density lipoprotein in NIDDM: its relationship to fatty acid composition. Diabetologia. 1995;38:1300–6.PubMedCrossRef

31.

de Man FH, Weverling-Rijnsburger AW, van der Laarse A, Smelt AH, Jukema JW, Blauw GJ. Not acute but chronic hypertriglyceridemia is associated with impaired endothelium-dependent vasodilation: reversal after lipid-lowering therapy by atorvastatin. Arterioscler Thromb Vasc Biol. 2000;20:744–50.PubMedCrossRef

32.

Williams SB, Cusco JA, Roddy MA, Johnstone MT, Creager MA. Impaired nitric oxide-mediated vasodilation in patients with non-insulin-dependent diabetes mellitus. J Am Coll Cardiol. 1996;27:567–74.PubMedCrossRef

33.

Beckman JA, Creager MA, Libby P. Diabetes and atherosclerosis: epidemiology, pathophysiology, and management. JAMA: the Journal of the American Medical Association. 2002;287:2570–81.CrossRef

34.

Fukumoto H, Naito Z, Asano G, Aramaki T. Immunohistochemical and morphometric evaluations of coronary atherosclerotic plaques associated with myocardial infarction and diabetes mellitus. J Atheroscler Thromb. 1998;5:29–35.PubMed

35.

Uemura S, Matsushita H, Li W, et al. Diabetes mellitus enhances vascular matrix metalloproteinase activity: role of oxidative stress. Circ Res. 2001;88:1291–8.PubMedCrossRef

36.

Vinik AI, Erbas T, Park TS, Nolan R, Pittenger GL. Platelet dysfunction in type 2 diabetes. Diabetes Care. 2001;24:1476–85.PubMedCrossRef

37.

Assert R, Scherk G, Bumbure A, Pirags V, Schatz H, Pfeiffer AF. Regulation of protein kinase C by short term hyperglycaemia in human platelets in vivo and in vitro. Diabetologia. 2001;44:188–95.PubMedCrossRef

38.

Alzahrani SH, Ajjan RA. Coagulation and fibrinolysis in diabetes. Diab Vasc Dis Res. 2010;7:260–73.PubMedCrossRef

39.

McGill Jr HC. McMahan CA, Malcom GT, Oalmann MC, Strong JP. Relation of glycohemoglobin and adiposity to atherosclerosis in youth. Pathobiological Determinants of Atherosclerosis in Youth (PDAY) Research Group. Arterioscler Thromb Vasc Biol. 1995;15:431–40.PubMedCrossRef

40.

Moreno PR, Murcia AM, Palacios IF, et al. Coronary composition and macrophage infiltration in atherectomy specimens from patients with diabetes mellitus. Circulation. 2000;102:2180–4.PubMed

41.

•• Burke AP, Kolodgie FD, Zieske A, et al. Morphologic findings of coronary atherosclerotic plaques in diabetics: a postmortem study. Arterioscler Thromb Vasc Biol. 2004;24:1266–71. The largest, most comprehensive pathological description of diabetic coronary atherosclerosis in humans.PubMedCrossRef

42.

Purushothaman KR, Purushothaman M, Muntner P, et al. Inflammation, neovascularization and intra-plaque hemorrhage are associated with increased reparative collagen content: implication for plaque progression in diabetic atherosclerosis. Vascular Medicine. 2011;16:103–8.PubMedCrossRef

43.

•• Nicholls SJ, Tuzcu EM, Kalidindi S, et al. Effect of diabetes on progression of coronary atherosclerosis and arterial remodeling: a pooled analysis of 5 intravascular ultrasound trials. J Am Coll Cardiol. 2008;52:255–62. The largest serial in vivo evaluation of diabetic coronary atherosclerosis.PubMedCrossRef

44.

Nigro J, Osman N, Dart AM, Little PJ. Insulin resistance and atherosclerosis. Endocr Rev. 2006;27:242–59.PubMedCrossRef

45.

• Bayturan O, Kapadia S, Nicholls SJ, et al. Clinical predictors of plaque progression despite very low levels of low-density lipoprotein cholesterol. J Am Coll Cardiol. 2010;55:2736–42. An important observation profiling factors implicated in the progression of coronary atherosclerosis despite aggressive lowering of LDL cholesterol levels, with the presence of diabetes mellitus being a multivariate predictor of disease progression.PubMedCrossRef

46.

Silva JA, Escobar A, Collins TJ, Ramee SR, White CJ. Unstable angina. A comparison of angioscopic findings between diabetic and nondiabetic patients. Circulation. 1995;92:1731–6.PubMed

47.

Burke GL, Evans GW, Riley WA, et al. Arterial wall thickness is associated with prevalent cardiovascular disease in middle-aged adults. The Atherosclerosis Risk in Communities (ARIC) Study. Stroke; A Journal of Cerebral Circulation. 1995;26:386–91.PubMedCrossRef

48.

O'Leary DH, Polak JF, Kronmal RA, Manolio TA, Burke GL, Wolfson Jr SK. Carotid-artery intima and media thickness as a risk factor for myocardial infarction and stroke in older adults. Cardiovascular Health Study Collaborative Research Group. N Engl J Med. 1999;340:14–22.PubMedCrossRef

49.

Niskanen L, Rauramaa R, Miettinen H, Haffner SM, Mercuri M, Uusitupa M. Carotid artery intima-media thickness in elderly patients with NIDDM and in nondiabetic subjects. Stroke; A Journal of Cerebral Circulation. 1996;27:1986–92.PubMedCrossRef

50.

Folsom AR, Chambless LE, Duncan BB, Gilbert AC, Pankow JS. Prediction of coronary heart disease in middle-aged adults with diabetes. Diabetes Care. 2003;26:2777–84.PubMedCrossRef

51.

Djaberi R, Beishuizen ED, Pereira AM, et al. Non-invasive cardiac imaging techniques and vascular tools for the assessment of cardiovascular disease in type 2 diabetes mellitus. Diabetologia. 2008;51:1581–93.PubMedCrossRef

52.

Schmermund A, Baumgart D, Gorge G, et al. Measuring the effect of risk factors on coronary atherosclerosis: coronary calcium score versus angiographic disease severity. J Am Coll Cardiol. 1998;31:1267–73.PubMedCrossRef

53.

Hoff JA, Quinn L, Sevrukov A, et al. The prevalence of coronary artery calcium among diabetic individuals without known coronary artery disease. J Am Coll Cardiol. 2003;41:1008–12.PubMedCrossRef

54.

Dabelea D, Kinney G, Snell-Bergeon JK, et al. Effect of type 1 diabetes on the gender difference in coronary artery calcification: a role for insulin resistance? The Coronary Artery Calcification in Type 1 Diabetes (CACTI) Study. Diabetes. 2003;52:2833–9.PubMedCrossRef

55.

Raggi P, Shaw LJ, Berman DS, Callister TQ. Prognostic value of coronary artery calcium screening in subjects with and without diabetes. J Am Coll Cardiol. 2004;43:1663–9.PubMedCrossRef

56.

Qu W, Le TT, Azen SP, et al. Value of coronary artery calcium scanning by computed tomography for predicting coronary heart disease in diabetic subjects. Diabetes Care. 2003;26:905–10.PubMedCrossRef

57.

Pundziute G, Schuijf JD, Jukema JW, et al. Noninvasive assessment of plaque characteristics with multislice computed tomography coronary angiography in symptomatic diabetic patients. Diabetes Care. 2007;30:1113–9.PubMedCrossRef

58.

Gao Y, Lu B, Sun ML, et al. Comparison of atherosclerotic plaque by computed tomography angiography in patients with and without diabetes mellitus and with known or suspected coronary artery disease. Am J Cardiol. 2011;108:809–13.PubMedCrossRef

59.

Scholte AJ, Schuijf JD, Kharagjitsingh AV, et al. Prevalence of coronary artery disease and plaque morphology assessed by multi-slice computed tomography coronary angiography and calcium scoring in asymptomatic patients with type 2 diabetes. Heart. 2008;94:290–5.PubMedCrossRef

Title: The Distinctive Nature of Atherosclerotic Vascular Disease in Diabetes: Pathophysiological and Morphological Insights
Authors: Rishi Puri
Yu Kataoka
Kiyoko Uno
Stephen J. Nicholls
Publication date: 01-06-2012
Publisher: Current Science Inc.
Published in: Current Diabetes Reports / Issue 3/2012
Print ISSN: 1534-4827
Electronic ISSN: 1539-0829
DOI: https://doi.org/10.1007/s11892-012-0270-y

Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Reserve your place

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin

Prof. Florian Limbourg

Prof. Anoop Chauhan

Developed by: Springer Medicine

Obesity Clinical Trial Summary

At a glance: The STEP trials

Read more

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Home
Congress Coverage
Clinical Collections
- Advances in Alzheimer’s
About Springer Medicine
Key Specialties