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Type 2 diabetes and cardiovascular disease: Have all risk factors the same strength?
Iciar Martín-Timón1, Cristina Sevillano-Collantes1, Amparo Segura-Galindo1
1Iciar Martín-Timón, Cristina Sevillano-Collantes, Amparo Segura-Galindo, Francisco Javier del Cañizo-Gómez, Section of Endocrinology, Hospital Universitario Infanta Leonor, Facultad de Medicina, Universidad Complutense, Madrid 28031, Spain.
Insights
Type 2 diabetes significantly increases cardiovascular disease risk due to traditional factors like obesity and hypertension. Non-traditional risk factors also play a crucial role in this heightened cardiovascular morbidity and mortality.
Area of Science:
- Cardiology
- Endocrinology
- Metabolic Diseases
Background:
- Type 2 diabetes mellitus (T2DM) is a chronic condition characterized by insulin deficiency or resistance.
- Patients with T2DM face a substantially elevated risk of cardiovascular morbidity and mortality compared to non-diabetic individuals.
- Traditional risk factors like hypertension, dyslipidemia, and obesity are prevalent in T2DM, contributing to cardiovascular disease (CVD).
Purpose of the Study:
- To review the impact of traditional and non-traditional risk factors on cardiovascular disease in T2DM patients.
- To elucidate the role of these risk factors in the pathogenesis of excess CVD mortality and morbidity in T2DM.
- To explore the concept of a shared etiology ('common soil') for T2DM and CVD.
Main Methods:
- Literature review focusing on traditional and non-traditional risk factors for CVD in T2DM.
- Analysis of the contribution of these factors to atherosclerosis development and clinical events.
- Synthesis of evidence regarding the interplay between diabetes and cardiovascular disease pathogenesis.
Main Results:
- While traditional risk factors explain some of the increased CVD risk in T2DM, they do not account for the entire excess.
- Non-traditional risk factors are implicated as significant contributors to CVD in T2DM.
- A complex interplay of both traditional and non-traditional factors drives atherosclerosis progression from endothelial dysfunction to clinical outcomes.
Conclusions:
- The heightened cardiovascular disease burden in T2DM results from a combination of traditional and non-traditional risk factors.
- Understanding these factors is crucial for managing CVD risk in patients with type 2 diabetes mellitus.
- Further research into non-traditional risk factors may reveal new therapeutic targets for preventing CVD in T2DM.
Abstract:
Diabetes mellitus is a chronic condition that occurs when the body cannot produce enough or effectively use of insulin. Compared with individuals without diabetes, patients with type 2 diabetes mellitus have a considerably higher risk of cardiovascular morbidity and mortality, and are disproportionately affected by cardiovascular disease. Most of this excess risk is it associated with an augmented prevalence of well-known risk factors such as hypertension, dyslipidaemia and obesity in these patients. However the improved cardiovascular disease in type 2 diabetes mellitus patients can not be attributed solely to the higher prevalence of traditional risk factors. Therefore other non-traditional risk factors may be important in people with type 2 diabetes mellitus. Cardiovascular disease is increased in type 2 diabetes mellitus subjects due to a complex combination of various traditional and non-traditional risk factors that have an important role to play in the beginning and the evolution of atherosclerosis over its long natural history from endothelial function to clinical events. Many of these risk factors could be common history for both diabetes mellitus and cardiovascular disease, reinforcing the postulate that both disorders come independently from "common soil". The objective of this review is to highlight the weight of traditional and non-traditional risk factors for cardiovascular disease in the setting of type 2 diabetes mellitus and discuss their position in the pathogenesis of the excess cardiovascular disease mortality and morbidity in these patients.
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