Current perspective. Diabetic vascular disease: from endothelial dysfunction to atherosclerosis

Area of Science:

• Cardiovascular Medicine
• Endocrinology
• Vascular Biology

Background:

• Cardiovascular complications are the primary cause of mortality in diabetic patients.
• Endothelial dysfunction is an early and critical step in atherosclerosis development, progression, and clinical manifestation.
• Endothelial dysfunction involves impaired vasodilation and an activated endothelium, creating a pro-inflammatory, proliferative, and procoagulatory state that drives atherogenesis.

Purpose of the Study:

• To review the multifactorial nature of endothelial dysfunction in diabetes.
• To examine the relationship between endothelial dysfunction, cardiovascular risk factors, and atherosclerosis.
• To discuss therapeutic strategies for improving endothelial function in diabetic individuals.

Main Methods:

• Literature review of studies on endothelial dysfunction in diabetes.
• Analysis of the interplay between diabetes, conventional cardiovascular risk factors, and endothelial function.
• Synthesis of current understanding of atherogenesis mechanisms in diabetes.

Main Results:

• Endothelial dysfunction is a central mechanism linking diabetes to accelerated atherosclerosis.
• Synergistic interactions among diabetes-related cardiovascular risk factors exacerbate endothelial dysfunction and vascular damage.
• The pro-inflammatory and pro-thrombotic state of endothelial activation promotes cardiovascular events.

Conclusions:

• Endothelial dysfunction is a critical, multifactorial contributor to cardiovascular complications in diabetes.
• Targeting endothelial dysfunction offers a promising therapeutic avenue for managing cardiovascular risk in diabetes.
• Further research is needed to elucidate specific mechanisms and optimize treatment strategies.