TY - JOUR
T1 - Pathogenesis and pathophysiology of accelerated atherosclerosis in the diabetic heart
AU - D'Souza, Alicia
AU - Hussain, Munir
AU - Howarth, Frank C.
AU - Woods, Niall M.
AU - Bidasee, Keshore
AU - Singh, Jaipaul
PY - 2009
Y1 - 2009
N2 - It has been established that atherosclerotic coronary artery disease is more frequent and more severe in diabetic compared to non-diabetic subjects, but the reason for the excess risk of developing coronary macroangiopathy in diabetes remains incompletely characterized. Various biochemical mechanisms speculated to being at the ''heart'' of diabetic cardiac and coronary macroangiopathy are reviewed in the present article. In doing so, this article presents evidence that the labyrinthine interactions of hyperglycemia, insulin resistance, and dyslipidemia in diabetes result in a pro-atherogenic phenotype. Furthermore, the diabetic milieu yields a complex (dys)metabolic environment characterized by chronic inflammation, pro-coagulability, impaired fibrinolysis, neovascularization abnormalities, and microvascular defects that cumulatively alter blood rheology, artery structure, and homeostasis of the endothelium. The contributory influences of these factors in the pathophysiology of coronary artery disease in diabetes are also discussed.
AB - It has been established that atherosclerotic coronary artery disease is more frequent and more severe in diabetic compared to non-diabetic subjects, but the reason for the excess risk of developing coronary macroangiopathy in diabetes remains incompletely characterized. Various biochemical mechanisms speculated to being at the ''heart'' of diabetic cardiac and coronary macroangiopathy are reviewed in the present article. In doing so, this article presents evidence that the labyrinthine interactions of hyperglycemia, insulin resistance, and dyslipidemia in diabetes result in a pro-atherogenic phenotype. Furthermore, the diabetic milieu yields a complex (dys)metabolic environment characterized by chronic inflammation, pro-coagulability, impaired fibrinolysis, neovascularization abnormalities, and microvascular defects that cumulatively alter blood rheology, artery structure, and homeostasis of the endothelium. The contributory influences of these factors in the pathophysiology of coronary artery disease in diabetes are also discussed.
KW - Coronary artery disease hyperglycemia
KW - Diabetes mellitus
KW - Endothelial dysfunction
UR - http://www.scopus.com/inward/record.url?scp=74049135423&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=74049135423&partnerID=8YFLogxK
U2 - 10.1007/s11010-009-0148-8
DO - 10.1007/s11010-009-0148-8
M3 - Review article
C2 - 19466528
AN - SCOPUS:74049135423
SN - 0300-8177
VL - 331
SP - 89
EP - 116
JO - Molecular and cellular biochemistry
JF - Molecular and cellular biochemistry
IS - 1-2
ER -