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Diabetic macroangiopathy and atherosclerosis
J L Andresen1, L M Rasmussen, T Ledet
1Research Laboratory for Biochemical Pathology, Kommunehospitalet, Aarhus, Denmark.
Diabetes
|July 1, 1996
Summary
Diabetes may cause specific large vessel disease (diabetic macroangiopathy) distinct from atherosclerosis. This non-atherosclerotic condition involves abnormal material accumulation in vessel walls, suggesting a new focus for treatment.
Area of Science:
- Vascular Biology
- Diabetology
- Pathogenesis
Background:
- The prevailing view links diabetes to accelerated atherosclerosis.
- However, evidence suggests a distinct diabetic large vessel disease may exist.
Purpose of the Study:
- To analyze published data on large vessel disease pathogenesis in diabetes.
- To propose diabetic macroangiopathy as a distinct pathological entity.
Main Methods:
- Comparative analysis of existing literature on diabetic large vessel disease.
- Review of histopathological findings in diabetic patients' large vessels.
Main Results:
- Observed accumulation of periodic acid-Schiff (PAS)-positive material (laminin, fibronectin, type IV collagen), hyaluronic acid, connective tissue, and calcium in large vessels.
- These changes occur independently of atherosclerosis in diabetic patients.
- Data supports a constellation of non-atherosclerotic large vessel abnormalities.
Conclusions:
- Diabetic macroangiopathy, characterized by non-atherosclerotic changes, is a more fruitful hypothesis than linking diabetes solely to accelerated atherosclerosis.
- This concept offers a causal link to diabetes' abnormal metabolism, guiding future research for prevention and treatment.