Chakraborty Snigdha, Verma Anjali, Garg Rajeev, Singh Jyoti, Verma Hitesh
Overseas R & D Centre, Overseas HealthCare Pvt Ltd., Phillaur, Punjab, India.
Department of Food Technology and Nutrition, School of Agriculture, Lovely Professional University, Phagwara, Punjab, India.
Clin Med Insights Endocrinol Diabetes. 2023 Dec 25;16:11795514231220780. doi: 10.1177/11795514231220780. eCollection 2023.
A complex metabolic condition referred to as Type 2 diabetes mellitus (T2DM) is characterized by insulin resistance (IR) and decreased insulin production. Obesity, dyslipidemia, hypertension, and chronic inflammation are just a few of the cardiometabolic illnesses that people with T2DM are more likely to acquire and results in cardiovascular issues. It is essential to comprehend the mechanistic insights into these risk variables in order to prevent and manage cardiovascular problems in T2DM effectively. Impaired glycemic control leads to upregulation of De novo lipogenesis (DNL), promote hepatic triglyceride (TG) synthesis, worsening dyslipidemia that is accompanied by low levels of high density lipoprotein cholesterol (HDL-C) and high amounts of small, dense low-density lipoprotein cholesterol (LDL-C) further developing atherosclerosis. By causing endothelial dysfunction, oxidative stress, and chronic inflammation, chronic hyperglycemia worsens already existing cardiometabolic risk factors. Vasoconstriction, inflammation, and platelet aggregation are caused by endothelial dysfunction, which is characterized by decreased nitric oxide production, increased release of vasoconstrictors, proinflammatory cytokines, and adhesion molecules. The loop of IR and endothelial dysfunction is sustained by chronic inflammation fueled by inflammatory mediators produced in adipose tissue. Infiltrating inflammatory cells exacerbate inflammation and the development of plaque in the artery wall. In addition, the combination of chronic inflammation, dyslipidemia, and IR contributes to the emergence of hypertension, a prevalent comorbidity in T2DM. The ability to target therapies and management techniques is made possible by improvements in our knowledge of these mechanistic insights. Aim of present review is to enhance our current understanding of the mechanistic insights into the cardiometabolic risk factors related to T2DM provides important details into the interaction of pathophysiological processes resulting in cardiovascular problems. Understanding these pathways will enable us to create efficient plans for the prevention, detection, and treatment of cardiovascular problems in T2DM patients, ultimately leading to better overall health outcomes.
一种被称为2型糖尿病(T2DM)的复杂代谢状况,其特征为胰岛素抵抗(IR)和胰岛素分泌减少。肥胖、血脂异常、高血压和慢性炎症只是T2DM患者更易患上的一些心脏代谢疾病,这些疾病会引发心血管问题。为了有效预防和管理T2DM患者的心血管问题,理解这些风险变量的机制性见解至关重要。血糖控制受损会导致从头脂肪生成(DNL)上调,促进肝脏甘油三酯(TG)合成,使血脂异常恶化,同时伴有高密度脂蛋白胆固醇(HDL-C)水平降低和大量小而密的低密度脂蛋白胆固醇(LDL-C)增加,进而发展为动脉粥样硬化。慢性高血糖通过引起内皮功能障碍、氧化应激和慢性炎症,使已有的心脏代谢危险因素恶化。内皮功能障碍的特征是一氧化氮生成减少、血管收缩剂、促炎细胞因子和黏附分子释放增加,从而导致血管收缩、炎症和血小板聚集。由脂肪组织产生的炎症介质引发的慢性炎症维持了IR和内皮功能障碍的循环。浸润的炎症细胞会加剧炎症以及动脉壁斑块的形成。此外,慢性炎症、血脂异常和IR共同作用导致了高血压的出现,高血压是T2DM中常见的合并症。我们对这些机制性见解的认识有所提高,使得靶向治疗和管理技术成为可能。本综述的目的是加深我们目前对与T2DM相关的心脏代谢危险因素的机制性见解的理解,为导致心血管问题的病理生理过程的相互作用提供重要细节。了解这些途径将使我们能够制定有效的计划,用于预防、检测和治疗T2DM患者的心血管问题,最终带来更好的整体健康结果。