[Diabetes mellitus as a risk factor for arteriosclerosis]

Area of Science:

• Cardiovascular Medicine
• Endocrinology
• Metabolic Disorders

Context:

• Diabetes mellitus is a significant risk factor for coronary heart disease and cerebrovascular disease.
• Diabetic patients frequently exhibit hyperlipidemia, with approximately 70% showing dyslipidemia, increasing complication risks.
• Lipoprotein metabolism abnormalities, promoting arteriosclerosis, are present even in normolipidemic diabetics.

Purpose:

• To review the various factors contributing to arteriosclerosis in diabetic patients.
• To highlight abnormal lipoprotein metabolism as a key factor in diabetic cardiovascular complications.
• To discuss specific atherogenic lipoproteins and other contributing factors in diabetes.

Summary:

• Diabetes mellitus elevates risks for cardiovascular and cerebrovascular diseases, exacerbated by frequent hyperlipidemia and dyslipidemia.
• Abnormalities in lipoprotein metabolism, including increased cholesterol in intermediate-density lipoproteins and the presence of glycated-LDL and small, dense LDL, are key contributors to arteriosclerosis in diabetics.
• Other factors like elevated lipoprotein (a), hyperinsulinemia, enhanced polyol pathway, and platelet dysfunction also promote arteriosclerosis in diabetic individuals.

Impact:

• Understanding these factors can lead to targeted interventions for preventing cardiovascular complications in diabetic patients.
• This review emphasizes the critical role of lipoprotein metabolism in diabetic arteriosclerosis, guiding future research and clinical practice.
• Identifying and managing dyslipidemia and other atherogenic factors in diabetics is crucial for reducing long-term morbidity and mortality.