Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2020 Mar 6;21(5):1835.
doi: 10.3390/ijms21051835.

The Diabetes Mellitus-Atherosclerosis Connection: The Role of Lipid and Glucose Metabolism and Chronic Inflammation

Affiliations
Review

The Diabetes Mellitus-Atherosclerosis Connection: The Role of Lipid and Glucose Metabolism and Chronic Inflammation

Anastasia Poznyak et al. Int J Mol Sci. .

Abstract

Diabetes mellitus comprises a group of carbohydrate metabolism disorders that share a common main feature of chronic hyperglycemia that results from defects of insulin secretion, insulin action, or both. Insulin is an important anabolic hormone, and its deficiency leads to various metabolic abnormalities in proteins, lipids, and carbohydrates. Atherosclerosis develops as a result of a multistep process ultimately leading to cardiovascular disease associated with high morbidity and mortality. Alteration of lipid metabolism is a risk factor and characteristic feature of atherosclerosis. Possible links between the two chronic disorders depending on altered metabolic pathways have been investigated in numerous studies. It was shown that both types of diabetes mellitus can actually induce atherosclerosis development or further accelerate its progression. Elevated glucose level, dyslipidemia, and other metabolic alterations that accompany the disease development are tightly involved in the pathogenesis of atherosclerosis at almost every step of the atherogenic process. Chronic inflammation is currently considered as one of the key factors in atherosclerosis development and is present starting from the earliest stages of the pathology initiation. It may also be regarded as one of the possible links between atherosclerosis and diabetes mellitus. However, the data available so far do not allow for developing effective anti-inflammatory therapeutic strategies that would stop atherosclerotic lesion progression or induce lesion reduction. In this review, we summarize the main aspects of diabetes mellitus that possibly affect the atherogenic process and its relationship with chronic inflammation. We also discuss the established pathophysiological features that link atherosclerosis and diabetes mellitus, such as oxidative stress, altered protein kinase signaling, and the role of certain miRNA and epigenetic modifications.

Keywords: atherosclerosis; cardiovascular disease; chronic inflammation; diabetes mellitus; hyperglycemia; lipid metabolism.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
A simplified scheme of the pathophysiological connection of diabetes mellitus and atherosclerosis. Dyslipidemia, hyperglycemia, and insulin resistance result in a spectrum of physiological changes, including the formation of atherogenic low-density lipoprotein (LDL), advanced glycation end products (AGE), and activation of pro-inflammatory signaling that impact different cell types of the arterial wall, resulting in atherosclerotic lesion development. SMC, smooth muscular cells.

Similar articles

Cited by

References

    1. Falk E. Pathogenesis of atherosclerosis. J. Am. Coll. Cardiol. 2006;47(Suppl. 8):C7. doi: 10.1016/j.jacc.2005.09.068. - DOI - PubMed
    1. Miname M.H., Santos R.D. Reducing cardiovascular risk in patients with familial hypercholesterolemia: Risk prediction and lipid management. Prog. Cardiovasc. Dis. 2019;62:414–422. doi: 10.1016/j.pcad.2019.10.003. - DOI - PubMed
    1. Summerhill V.I., Grechko A.V., Yet S.F., Sobenin I.A., Orekhov A.N. The atherogenic role of circulating modified lipids in atherosclerosis. Int. J. Mol. Sci. 2019;20:3561. doi: 10.3390/ijms20143561. - DOI - PMC - PubMed
    1. Taleb S. Inflammation in atherosclerosis. Arch. Cardiovasc. Dis. 2016;109:708–715. doi: 10.1016/j.acvd.2016.04.002. - DOI - PubMed
    1. Cheng F., Torzewski M., Degreif A., Rossmann H., Canisius A., Lackner K.J. Impact of glutathione peroxidase-1 deficiency on macrophage foam cell formation and proliferation: Implications for atherogenesis. PLoS ONE. 2013;8:e72063. doi: 10.1371/journal.pone.0072063. - DOI - PMC - PubMed
-