[Molecular mechanisms of endothelial dysfunction in diabetes mellitus]

Diabetes is a strong risk factor for vascular diseases. Recent studies have shown that disruption of endothelial cell function results in vascular injury. One of causes underlying the endothelial dysfunction in diabetics is hyperglycemia. Many epidemiological studies demonstrated that hyperglycemia increased the incidence of macrovascular diseases. In contrast to the microvascular complications in diabetes, however, the macrovascular complication often develops even in patients with good glycemic control, suggesting that some factors other than hyperglycemia may contribute to it. Insulin resistance is one of possible candidates for that. In fact, it is shown that insulin resistance is an independent risk factor for atherosclerosis. In this article, we reviewed recent hypothesis explaining how hyperglycemia or insulin resistant state caused endothelial dysfunction.