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Brief Reviews |
From Divisions of Preventive Medicine and Nutrition (I.J.G.) and Cardiology (I.J.G., H.M.D.), Department of Medicine, Columbia University, New York, NY.
Correspondence to Ira J. Goldberg, Medicine, 630 West 168th Street, New York, NY 10032. E-mail ijg3{at}columbia.edu
Series Editor: Richard A. Cohen
Diabetic Vascular Disease: Pathophysiological Mechanisms in the Diabetic Milieu and Therapeutic Implications
ATVB In Focus
Previous Brief Reviews in this Series:
Naka Y, Bucciarelli LG, Wendt T, Lee LK, Rong LL, Ramasamy R, Yan SF, Schmidt AM. RAGE axis: animal models and novel insights into the vascular complications of diabetes. 2004;24:13421349.
Natarajan R, Nadler JL. Lipid inflammatory mediators in diabetic vascular disease. 2004;24:15421548.
Rask-Madsen C, King GL. Proatherosclerotic mechanisms involving protein kinase C in diabetes and insulin resistance. 2005;25:487496.
Blaschke F, Takata Y, Caglayan E, Law RE, Hsueh WA. Obesity, peroxisome proliferator-activated receptor, and atherosclerosis in type 2 diabetes. 2006;26:2840.
| Abstract |
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Despite a plethora of in vitro data showing toxic effects of hyperglycemia, accelerated atherosclerosis does not always accompany diabetes in animals. This might result from genetic differences, time course, or because risk factors, such as hyperlipidemia, are present and overwhelm any toxic effects of hyperglycemia.
Key Words: macrovascular lipoproteins atherosclerosis hyperglycemia endothelial cells macrophages
| Introduction |
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The initial diagnosis of type 2 diabetes is commonly made during the presentation of a macrovascular disease complication. This is unlike the situation in type 1 diabetes, in which vascular disease complications are not manifest for, on average, over a decade.3 Disease and vascular calcification in patients with type 1 diabetes correlate with duration of disease, levels of glucose control, insulin resistance, and conventional risk factors.46
One hypothesis to explain the correlation of CHD and diabetes is that metabolic abnormalities associated with diabetes, and not overt hyperglycemia per se, accelerate macrovascular complications.7 Haffner et al8 reported that CHD is increased in prediabetic patients: people who have several metabolic abnormalities associated with type 2 diabetes but not fasting hyperglycemia or elevated glycosylated hemoglobin. These patients are often denoted as having the metabolic syndrome.9 Support for the hypothesis that conventional risk factors, and not hyperglycemia, is the culprit has come from the failure of glucose reduction to reduce CHD, despite reduction in microvascular disease.10,11 There are several reasons why clinical trials for atherosclerosis prevention might fail: the trial period might have been too short, the interventions might be needed before the onset of disease, and the reductions in glucose may have been too meager. Finally, it is possible that a glucose threshold must be crossed to alter vascular pathology. Other clinical trials are currently underway to test the effects of better glucose control in a large population of subjects with type 2 diabetes.12
A robust intervention to specifically assess the effects of hyperglycemia on vascular disease in type 1 diabetes was accomplished via the diabetes control and complications trial (DCCT). This trial compared 2 levels of glycemic control; one group received conventional therapy and the second had more intensive treatment leading to reduced HbA1C. At the initial completion of this trial, the intensively treated group with improved glucose control had a trend to fewer vascular events.10 The subjects were then followed-up for 6 years and re-evaluated. Intensive therapy was associated with a significant decrease in carotid artery intimal/media thickness.13 Thus, as has been surmised for many years, the extent of hyperglycemia affects vascular pathology. Subsequently, it was reported that the intensive treatment group developed significantly less vascular disease; all cardiovascular disease was reduced 42%.14 Because the development of clinical disease, as opposed to asymptomatic vascular pathology, requires a threshold level of arterial alterations, it is possible that the additional years of progression at a similar rate (because the 2 groups had merged to identical glucose control) occurred on top of different basal disease. The intensive treatment group, having a reduced basal pathology at the end of the initial 6 years, would have taken longer to reach events-producing pathology. There are other possibilities; renal disease was less in the intensive treatment group. Regardless, this landmark study demonstrates that control of glucose alters macrovascular disease exclusive of changes in blood pressure or lipids. The reasons for this can be conjectured from the clinical correlations. However, only experimental evidence is likely to convincingly illustrate mechanism(s) responsible for diabetic vascular disease.
One approach to understanding the relationship of diabetes and vascular disease is to ask whether diabetic lesions are distinct from those seen in other situations. Microvascular diseases lead to characteristic pathological changes in the eyes and kidneys. Although the extent and diffuse nature of atherosclerosis in patients with diabetes is often impressive, efforts to distinguish these lesions anatomically and clinically from hose of nondiabetic patients have been unsuccessful. Several recent reports imply that lesions might be more prone to rupture in the diabetic setting leaving evidence of intravascular thrombosis and/or repair.15,16 However, no pathological "fingerprint" has been found in the diseased diabetic artery.
| What Processes Cause Diabetic Toxicity? |
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Intracellular processes that cause pathological events are thought to involve hyperglycemic damage to endothelial cells.17 Endothelial cells, unlike many other cells, do not downregulate their glucose transporters when exposed to elevated glucose levels, and are thought to take up excess glucose in the setting of hyperglycemia. Within the cells, excess glucose metabolism increases reactive oxygen species (ROS) formation. This process is augmented if endothelial cells are also exposed to free fatty acids.21 ROS can also be generated by pathways regulated by aldose reductase (AR), phosphokinase C, and hexosamine.22 Other pathways altered by elevated intracellular glucose are thought to affect endothelial production of 12 lipoxygenase23 and other inflammatory molecules,24 alter eNOS25 or modify intracellular proteins by N-acetylglucosamine addition.26
Evidence for toxic effects of glucose on endothelium comes from experimental studies of endothelial function in vivo. Experimentally induced hyperglycemia and hyperinsulinemia decrease arterial vasodilation in healthy individuals.27,28,29 Hyperglycemia can directly impair arterial vasomotion vasodilation via increases in superoxide generation and subsequent decreases in endothelial nitric oxide availability29.30 Patients with obesity, insulin resistance, and diabetes have reduced endothelial function even without clinical evidence of cardiovascular disease.31,32,33 Although endothelial function measurement has not been used as a routine clinical screening tool, clinical studies have demonstrated that endothelial dysfunction is an independent predictor of future cardiovascular events.34,35 Therapeutic agents such as metformin and PPAR
agonists partially restore endothelial function in patients with diabetes.36,37
An alternative explanation for the toxic effects of hyperglycemia is that elevated plasma levels of glucose nonenzymatically glycate circulating and matrix proteins. Extracellular proteins containing advanced glycation endproducts (AGEs) directly affect cell function, arterial wall stiffness, or gene expression of interacting cells. AGEs are ligands for a number of scavenger receptors including SR-A,38 SR-B1, and CD36,39 and the receptor for AGEs (RAGE). Moreover, AGE treatment will increase expression of scavenger receptors.40 RAGE ligation generates endothelial cell ROS.41 Two lines of evidence support the theory that AGEs mediate diabetic complications: (1) infusions of soluble RAGE, which is presumed to complex AGEs, reduce42 and stabilize atherosclerotic lesions,43 and inhibition of AGE formation reduces lesions;44 (2) diets enriched in AGEs promote lesions.45 Glycosylated proteins are, however, not the only ligands for RAGE and RAGE activation mediates multiple processes including cell differentiation, migration, and apoptosis.46
Although one would expect that AGE interaction with RAGE primarily involves an extracellular protein binding to a cell surface receptor, it has been conjectured that intracellular AGEs can be released, leading to either autocrine or paracrine cell activation.20 In addition, AGE formation on matrix proteins increases monocyte retention; glycated collagen is a ligand for the scavenger receptors.38
| Could Decreased Insulin Actions Be Atherogenic? |
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There are data implicating lack of insulin actions in abnormalities of macrophage biology: insulin receptor-deficient macrophages have greater expression of SR-A and CD36 and augmented uptake of modified lipoproteins.51 It is also reported that hyperglycemia alone will increase expression of scavenger receptors.52
| How Does Diabetes Change Lipoprotein Metabolism in Humans and Animals? |
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Diabetes in experimental animals often leads to major changes in plasma lipoproteins and these changes may swamp any deleterious effects of glucose/insulin resistance on the artery. In monkeys and pigs, diabetes leads to greater hyperlipidemia. Mice have a variable response. Wild-type mice, human apoB transgenics, and heterozygous LDL receptor knockout mice have minimal or no change in plasma lipids with either diet or streptozotocin (STZ)-induced diabetes. In contrast apoE knockout mice develop elevations of cholesterol with STZ diabetes. The reasons for the hypercholesterolemia in this model were studied by Ebara et al.57 Catabolism of remnant lipoproteins was reduced in STZ-treated apoE knockout mice and this effect was attributed to a reduction in liver trapping associated with reduced proteoglycan production and loss of normal lipoprotein receptor uptake pathways.
LDL receptor knockout mice often more than double their plasma cholesterol in the setting of islet destruction58,59 or deficiency of leptin actions.60,61 The reasons for this are not known but might reflect reduced clearance pathways through LDL receptorrelated protein (LRP) and/or scavenger receptors, increased lipoprotein production caused by changes in apoB production associated with intrahepatic signaling62 or fatty acid rescue of apoB from degradation,63 increased MTP expression,64 or greater ingestion of the atherogenic diet. Leptin deficient mice also have increased HDL levels65 associated with defective apoAI clearance66 and reduced scavenger receptor expression.51
| Does Diabetes Increase Atherosclerosis in Animals? |
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A variety of animal models have been used to try to reproduce the relationship between diabetes and macrovascular disease. In a classic experiment, Duff et al67 used alloxan to produce diabetes in cholesterol-fed rabbits. In a seemingly paradoxical result, the diabetic rabbits had less atherosclerosis. This atherosclerosis was increased with insulin treatment,68 probably because the very large lipoproteins in diabetic rabbits that are unable to enter the artery wall69 are converted to smaller more atherogenic particles. Insulin infusion, by itself, is not atherosclerotic in this model.70
Limited studies have been performed in monkeys made diabetic using STZ to destroy pancreatic islets. These animals develop hyperlipidemia and, of course, greater atherosclerosis.71 In some studies, the monkeys have increased LDL retention and reduced HDL.72,73
Diets in genetically susceptible strains and chemical destruction of islets have been used to create diabetic pigs. Alloxan-treated diabetic pigs have increased atherosclerosis;74 however, plasma LDL was more than doubled by the diabetes. A later study examined the effect of type 1 diabetes in high-fat diet, STZ-treated pigs.75 Although the induction of diabetes resulted in an increase in plasma triglyceride with no change in LDL cholesterol in the high-fat diet fed pigs, there was worsening of the extent and severity of atherosclerosis in the diabetic compared with the nondiabetic pigs. In both of these studies, the effects of diabetes cannot be discerned because increased lipoprotein levels alone should increase atherosclerosis. Genetic strains of pigs that become diabetic with a fat-rich diet are being bred and studied for atherosclerosis development.
| Do Mouse Models Reproduce the Relationship Between Diabetes and Atherosclerosis? |
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High-fat diets produce insulin resistant diabetes in mice with elevated blood sugars between 180 and 300 mg/dL that are in the range seen in human type 2 diabetes.76 However, the response to this diet is strain-dependent; C57BL6, the strain used for most atherosclerosis and cardiomyopathy studies, is relatively resistant to diet induced hyperglycemia. Moreover, a number of genetic modifications leading to diabetes show diminished or no effect in this strain.77
Mouse strains differ in their vascular response to diabetes and hyperlipidemia. Kunjathoor et al78 assessed atherosclerosis in several strains of STZ-treated and cholic acid-containing (Paigen) diet fed mice. Only BALB/c mice developed a small increase in lesions. Studies to assess the effects diabetes on hyperlipidemic BalbC mice are currently underway (LeBoeuf, personal communication).
Significant atherosclerosis does not develop in the mouse or other animals without plasma hyperlipidemia. Development of several lines of genetically altered mice with hyperlipidemia and vascular disease has shown that significant atherosclerosis does not occur without lipid infiltration.
| The Apoe Knockout Mice Have Increased Diabetic Atherosclerosis, but This Is Often Associated With Increased Cholesterol |
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Accompanying increased hypercholesterolemia obscures the effects of leptin-deficient hyperglycemia and insulin deficiency in apoE knockout mice. When apoE knockout was crossed onto the db/db leptin receptor-deficient background, plasma cholesterol doubled, and this likely led to greater lesion size.83 A recent paper using the leptin deficient ob model showed increased aortic sinus lesions; but plasma cholesterol on this 12% fat diet increased
50%.84
| The ApoB Transgenics Do Not Normally Develop Diabetes-Induced Lipid Abnormalities or Accelerated Atherosclerosis |
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| The LDL Receptor Knockout Is Probably the Best Studied Model, but Lipid Abnormalities Often Obscure Diabetic Toxicity |
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This model also is amenable to diet induced insulin resistance and hyperglycemia.91 Insulin resistance by itself did not alter lesion area.92
In other studies diabetic LDL receptor knockout mice developed more lesions associated with a marked increase in plasma cholesterol.58 A recent paper described experiments in which early lesions in chow fed mice were increased with viral destruction of the pancreatic islets.59 However, with a diet containing cholesterol and fat, diabetic mice had much greater levels of blood lipids, and a distinct effect of diabetes, rather than hyperlipidemia, was no longer apparent.
Heterozygous LDL receptor knockout mice develop atherosclerosis when placed on a cholesterol/cholic-acid diet.93,94 In one study, imposition of STZ diabetes increased lesion size at the aortic root in these mice.95
| Are Mice Missing an Enzyme That Mediates the Pathological Effects of Glucose? |
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One pathway leading to greater amounts of ROS is the polyol pathway mediated by AR. AR reduces the 1 carbon on glucose to create sorbitol, which then forms NADH as the sorbitol is oxidized to fructose. Downstream effects of ROS include DNA strand breaks, activation of the repair enzyme poly (ADPribose) polymerase (PARP), inhibition of glyceraldehyde-3 phosphate dehydrogenase, and activation of 4 potentially deleterious pathways: flux through the hexosamine pathway, AGE production, synthesis of diacylglycerol leading to activation of protein kinase C (PKC), and further shunting of glucose into the polyol pathway.18 Although these consequences of hyperglycemia are felt to be especially important in endothelial cells, in other cells such as macrophages, toxic effects of glucose might also involve greater substrate flux though the polyol pathway.
AR is expressed at very low levels in the mouse and mouse hearts and macrophages have much less AR expression than comparable human tissues.95 Moreover, investigators who have sequenced the mouse AR gene claim that a genetic alteration in mice leads to an AR with reduced activity (K. Gabbay, personal communication). Transgenic mice expressing this enzyme via mouse major histocompatibility antigen class I promoter have expression levels that are more similar to those in humans.95 This transgene and an AR transgene expressed via the myelin promoter increased neuropathy in diabetic mice.96,97 AR local and generalized overexpression also increased cataract formation.98,99 Ramasamy has studied the expression of AR in cardiac muscle and its effects on ischemia-reperfusion injury in isolated hearts. AR-inhibitors protect100 and AR transgenic expression increases101 injury. Most intriguing is the recent clinical study from Youngs laboratory,102 showing that diabetic humans receiving newer generation AR inhibitors to treat neuropathy had improved cardiac function compared with a placebo-treated group. Thus, AR alters a number of diabetes complications, and these might be via different mechanisms. Human AR expression increased lesion size in STZ-treated, but not nondiabetic, homozygous, and heterozygous LDL receptor knockout mice.95 The observation that this gene only altered disease in diabetic animals suggests that it mediates a process only found with hyperglycemia or insulin deficiency.
It should be noted that AR has also been postulated to have anti-inflammatory actions because it is expressed in macrophages and smooth muscle cells as a reaction to toxic lipid products produced during vasculitis.103
One of the downstream products of AR is fructose. Fructose has been used in several diets to induced hyperlipidemia without causing hyperglycemia. When normalized for plasma cholesterol levels, in some studies fructose ingestion is associated with greater lesion development.92
| Conclusion |
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| Acknowledgments |
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Sources of Funding
The author received support from NIH grants HL073191 and 072147 and HL705224 (A.M.D.C.C.).
Disclosures
None.
| Footnotes |
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| References |
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2. Grundy SM, Benjamin IJ, Burke GL, Chait A, Eckel RH, Howard BV, Mitch W, Smith SC Jr, Sowers JR. Diabetes and cardiovascular disease: a statement for healthcare professionals from the Am Heart Association. Circulation. 1999; 100: 11341146.
3. Krolewski AS, Kosinski EJ, Warram JH, Leland OS, Busick EJ, Asmal AC, Rand LI, Christlieb AR, Bradley RF, Kahn CR. Magnitude and determinants of coronary artery disease in juvenile-onset, insulin-dependent diabetes mellitus. Am J Cardiol. 1987; 59: 750755.[CrossRef][Medline] [Order article via Infotrieve]
4. Maser RE, Wolfson SK, Jr., Ellis D, Stein EA, Drash AL, Becker DJ, Dorman JS, Orchard TJ. Cardiovascular disease and arterial calcification in insulin-dependent diabetes mellitus: interrelations and risk factor profiles. Pittsburgh Epidemiology of Diabetes Complications Study-V. Arterioscler Thromb. 1991; 11: 958965.
5. Snell-Bergeon JK, Hokanson JE, Jensen L, MacKenzie T, Kinney G, Dabelea D, Eckel RH, Ehrlich J, Garg S, Rewers M. Progression of coronary artery calcification in type 1 diabetes: the importance of glycemic control. Diabetes Care. 2003; 26: 29232928.
6. Dabelea D, Kinney G, Snell-Bergeon JK, Hokanson JE, Eckel RH, Ehrlich J, Garg S, Hamman RF, Rewers M. Effect of type 1 diabetes on the gender difference in coronary artery calcification: a role for insulin resistance? The Coronary Artery Calcification in Type 1 Diabetes (CACTI) Study. Diabetes. 2003; 52: 28332839.
7. Haffner SM. Insulin resistance, inflammation, and the prediabetic state. Am J Cardiol. 2003; 92: 18J26J.[Medline] [Order article via Infotrieve]
8. Haffner SM, Mykkanen L, Festa A, Burke JP, Stern MP. Insulin-resistant prediabetic subjects have more atherogenic risk factors than insulin-sensitive prediabetic subjects: implications for preventing coronary heart disease during the prediabetic state. Circulation. 2000; 101: 975980.
9. Executive Summary of The Third Report of The National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol In Adults (Adult Treatment Panel III). Jama. 2001; 285: 24862497.
10. The Diabetes Control and Complications Trial Research Group. Effect of intensive diabetes management on macrovascular events and risk factors in the Diabetes Control and Complications Trial. Am J Cardiol. 1995; 75: 894903.[CrossRef][Medline] [Order article via Infotrieve]
11. UK Prospective Diabetes Study (UKPDS) Group. Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33). UK Prospective Diabetes Study (UKPDS) Group. Lancet. 1998; 352: 837853.[CrossRef][Medline] [Order article via Infotrieve]
12. Prisant LM. Clinical trials and lipid guidelines for type II diabetes. J Clin Pharmacol. 2004; 44: 423430.
13. Nathan DM, Lachin J, Cleary P, Orchard T, Brillon DJ, Backlund JY, OLeary DH, Genuth S. Intensive diabetes therapy and carotid intima-media thickness in type 1 diabetes mellitus. N Engl J Med. 2003; 348: 22942303.
14. Nathan DM, Cleary PA, Backlund JY, Genuth SM, Lachin JM, Orchard TJ, Raskin P, Zinman B. Intensive diabetes treatment and cardiovascular disease in patients with type 1 diabetes. N Engl J Med. 2005; 353: 26432653.
15. Moreno PR, Murcia AM, Palacios IF, Leon MN, Bernardi VH, Fuster V, Fallon JT. Coronary composition and macrophage infiltration in atherectomy specimens from patients with diabetes mellitus. Circulation. 2000; 102: 21802184.
16. Virmani R, Burke AP, Kolodgie F Morphological characteristics of coronary atherosclerosis in diabetes mellitus. Can J Cardiol. 2006; 22 (Suppl B): 81B84B.[Medline] [Order article via Infotrieve]
17. Brownlee M. Biochemistry and molecular cell biology of diabetic complications. Nature. 2001; 414: 813820.[CrossRef][Medline] [Order article via Infotrieve]
18. Reusch JE. Diabetes, microvascular complications, and cardiovascular complications: what is it about glucose? J Clin Invest. 2003; 112: 986988.[CrossRef][Medline] [Order article via Infotrieve]
19. Goldberg IJ. Why does diabetes increase atherosclerosis? I dont know! J Clin Invest. 2004; 114: 613615.[CrossRef][Medline] [Order article via Infotrieve]
20. Xiong WC, Stern DM. The marriage of glucose and blood vessels: it isnt all that sweet. Cell Metab. 2005; 2: 212215.[CrossRef][Medline] [Order article via Infotrieve]
21. Du X, Edelstein D, Obici S, Higham N, Zou MH, Brownlee M. Insulin resistance reduces arterial prostacyclin synthase and eNOS activities by increasing endothelial fatty acid oxidation. J Clin Invest. 2006.
22. Jay D, Hitomi H, Griendling KK. Oxidative stress and diabetic cardiovascular complications. Free Radic Biol Med. 2006; 40: 183192.[CrossRef][Medline] [Order article via Infotrieve]
23. Natarajan R, Gerrity RG, Gu JL, Lanting L, Thomas L, Nadler JL. Role of 12-lipoxygenase and oxidant stress in hyperglycaemia-induced acceleration of atherosclerosis in a diabetic pig model. Diabetologia. 2002; 45: 125133.[CrossRef][Medline] [Order article via Infotrieve]
24. Srinivasan S, Yeh M, Danziger EC, Hatley ME, Riggan AE, Leitinger N, Berliner JA, Hedrick CC. Glucose regulates monocyte adhesion through endothelial production of interleukin-8. Circ Res. 2003; 92: 371377.
25. Srinivasan S, Hatley ME, Bolick DT, Palmer LA, Edelstein D, Brownlee M, Hedrick CC. Hyperglycaemia-induced superoxide production decreases eNOS expression via AP-1 activation in aortic endothelial cells. Diabetologia. 2004; 47: 17271734.[CrossRef][Medline] [Order article via Infotrieve]
26. Wells L, Hart GW. O-GlcNAc turns twenty: functional implications for post-translational modification of nuclear and cytosolic proteins with a sugar. FEBS Lett. 2003; 546: 154158.[CrossRef][Medline] [Order article via Infotrieve]
27. Arcaro G, Cretti A, Balzano S, Lechi A, Muggeo M, Bonora E, Bonadonna RC. Insulin causes endothelial dysfunction in humans: sites and mechanisms. Circulation. 2002; 105: 576582.
28. Campia U, Sullivan G, Bryant MB, Waclawiw MA, Quon MJ, Panza JA. Insulin impairs endothelium-dependent vasodilation independent of insulin sensitivity or lipid profile. Am J Physiol Heart Circ Physiol. 2004; 286: H76H82.
29. Beckman JA, Goldfine AB, Gordon MB, Creager MA. Ascorbate restores endothelium-dependent vasodilation impaired by acute hyperglycemia in humans. Circulation. 2001; 103: 16181623.
30. Beckman JA, Goldfine AB, Gordon MB, Garrett LA, Creager MA. Inhibition of protein kinase Cbeta prevents impaired endothelium-dependent vasodilation caused by hyperglycemia in humans. Circ Res. 2002; 90: 107111.
31. Steinberg HO, Chaker H, Leaming R, Johnson A, Brechtel G, Baron AD. Obesity/insulin resistance is associated with endothelial dysfunction. Implications for the syndrome of insulin resistance. J Clin Invest. 1996; 97: 26012610.[Medline] [Order article via Infotrieve]
32. Caballero AE, Arora S, Saouaf R, Lim SC, Smakowski P, Park JY, King GL, LoGerfo FW, Horton ES, Veves A. Microvascular and macrovascular reactivity is reduced in subjects at risk for type 2 diabetes. Diabetes. 1999; 48: 18561862.[Abstract]
33. Plump AS, Erickson SK, Weng W, Partin JS, Breslow JL, Williams DL. Apolipoprotein A-I is required for cholesteryl ester accumulation in steroidogenic cells and for normal adrenal steroid production. J Clin Invest. 1996; 97: 26602671.[Medline] [Order article via Infotrieve]
34. Halcox JP, Schenke WH, Zalos G, Mincemoyer R, Prasad A, Waclawiw MA, Nour KR, Quyyumi AA. Prognostic value of coronary vascular endothelial dysfunction. Circulation. 2002; 106: 653658.
35. Widlansky ME, Gokce N, Keaney JF, Jr., Vita JA. The clinical implications of endothelial dysfunction. J Am Coll Cardiol. 2003; 42: 11491160.
36. Mather KJ, Verma S, Anderson TJ. Improved endothelial function with metformin in type 2 diabetes mellitus. J Am Coll Cardiol. 2001; 37: 13441350.
37. Sidhu JS, Cowan D, Kaski JC. Effects of rosiglitazone on endothelial function in men with coronary artery disease without diabetes mellitus. Am J Cardiol. 2004; 94: 151156.[Medline] [Order article via Infotrieve]
38. El Khoury J, Thomas CA, Loike JD, Hickman SE, Cao L, Silverstein SC. Macrophages adhere to glucose-modified basement membrane collagen IV via their scavenger receptors. J Biol Chem. 1994; 269: 1019710200.
39. Miyazaki A, Nakayama H, Horiuchi S. Scavenger receptors that recognize advanced glycation end products. Trends Cardiovasc Med. 2002; 12: 258262.[CrossRef][Medline] [Order article via Infotrieve]
40. Iwashima Y, Eto M, Hata A, Kaku K, Horiuchi S, Ushikubi F, Sano H. Advanced glycation end products-induced gene expression of scavenger receptors in cultured human monocyte-derived macrophages. Biochem Biophys Res Commun. 2000; 277: 368380.[CrossRef][Medline] [Order article via Infotrieve]
41. Basta G, Lazzerini G, Massaro M, Simoncini T, Tanganelli P, Fu C, Kislinger T, Stern DM, Schmidt AM, De Caterina R. Advanced glycation end products activate endothelium through signal-transduction receptor RAGE: a mechanism for amplification of inflammatory responses. Circulation. 2002; 105: 816822.
42. Park L, Raman KG, Lee KJ, Lu Y, Ferran LJ Jr, Chow WS, Stern D, Schmidt AM. Suppression of accelerated diabetic atherosclerosis by the soluble receptor for advanced glycation endproducts. Nat Med. 1998; 4: 10251031.[CrossRef][Medline] [Order article via Infotrieve]
43. Bucciarelli LG, Wendt T, Qu W, Lu Y, Lalla E, Rong LL, Goova MT, Moser B, Kislinger T, Lee DC, Kashyap Y, Stern DM, Schmidt AM. RAGE blockade stabilizes established atherosclerosis in diabetic apolipoprotein E-null mice. Circulation. 2002; 106: 28272835.
44. Forbes JM, Yee LT, Thallas V, Lassila M, Candido R, Jandeleit-Dahm KA, Thomas MC, Burns WC, Deemer EK, Thorpe SM, Cooper ME, Allen TJ. Advanced glycation end product interventions reduce diabetes-accelerated atherosclerosis. Diabetes. 2004; 53: 18131823.
45. Akamine EH, Hohman TC, Nigro D, Carvalho MH, de Cassia Tostes R, Fortes ZB. Minalrestat, an aldose reductase inhibitor, corrects the impaired microvascular reactivity in diabetes. J Pharmacol Exp Ther. 2003; 304: 12361242.
46. Riuzzi F, Sorci G, Donato R. The Amphoterin (HMGB1)/Receptor for Advanced Glycation End Products (RAGE) Pair Modulates Myoblast Proliferation, Apoptosis, Adhesiveness, Migration, and Invasiveness. J Biol Chem. 2006; 281: 82428253.
47. Bloomgarden ZT. Inflammation, atherosclerosis, and aspects of insulin action. Diabetes Care. 2005; 28: 23122319.
48. Stuhlinger MC, Abbasi F, Chu JW, Lamendola C, McLaughlin TL, Cooke JP, Reaven GM, Tsao PS. Relationship between insulin resistance and an endogenous nitric oxide synthase inhibitor. JAMA. 2002; 287: 14201426.
49. Semenkovich CF. Fatty acid metabolism and vascular disease. Trends Cardiovasc Med. 2004; 14: 7276.[CrossRef][Medline] [Order article via Infotrieve]
50. Ziouzenkova O, Perrey S, Asatryan L, Hwang J, MacNaul KL, Moller DE, Rader DJ, Sevanian A, Zechner R, Hoefler G, Plutzky J. Lipolysis of triglyceride-rich lipoproteins generates PPAR ligands: evidence for an antiinflammatory role for lipoprotein lipase. Proc Natl Acad Sci U S A. 2003; 100: 27302735.
51. Liang CP, Han S, Okamoto H, Carnemolla R, Tabas I, Accili D, Tall AR. Increased CD36 protein as a response to defective insulin signaling in macrophages. J Clin Invest. 2004; 113: 764773.[CrossRef][Medline] [Order article via Infotrieve]
52. Fukuhara-Takaki K, Sakai M, Sakamoto YI, Takeya M, Horiuchi S. Expression of class A scavenger receptor is enhanced by high glucose in vitro and under diabetic conditions in vivo; one mechanism for an increased rate of atherosclerosis in diabetes. J Biol Chem. 2004.
53. Goldberg IJ. Diabetic dyslipidemia: causes and consequences. J Clin Endocrinol Metab. 2001; 86: 965971.
54. Ginsberg HN. Diabetic dyslipidemia: basic mechanisms underlying the common hypertriglyceridemia and low HDL cholesterol levels. Diabetes. 1996; 45 (Suppl 3): S27S30.[Medline] [Order article via Infotrieve]
55. Inukai K, Nakashima Y, Watanabe M, Kurihara S, Awata T, Katagiri H, Oka Y, Katayama S. ANGPTL3 is increased in both insulin-deficient and -resistant diabetic states. Biochem Biophys Res Commun. 2004; 317: 10751079.[CrossRef][Medline] [Order article via Infotrieve]
56. Ginsberg HN, Tuck C. Diabetes and dyslipidemia. Curr Diab Rep. 2001; 1: 9395.[Medline] [Order article via Infotrieve]
57. Ebara T, Conde K, Kako Y, Liu Y, Xu Y, Ramakrishnan R, Goldberg IJ, Shachter NS. Delayed catabolism of apoB-48 lipoproteins due to decreased heparan sulfate proteoglycan production in diabetic mice. J Clin Invest. 2000; 105: 18071818.[Medline] [Order article via Infotrieve]
58. Keren P, George J, Shaish A, Levkovitz H, Janakovic Z, Afek A, Goldberg I, Kopolovic J, Keren G, Harats D. Effect of hyperglycemia and hyperlipidemia on atherosclerosis in LDL receptor-deficient mice: establishment of a combined model and association with heat shock protein 65 immunity. Diabetes. 2000; 49: 10641069.[Abstract]
59. Renard CB, Kramer F, Johansson F, Lamharzi N, Tannock LR, von Herrath MG, Chait A, Bornfeldt KE. Diabetes and diabetes-associated lipid abnormalities have distinct effects on initiation and progression of atherosclerotic lesions. J Clin Invest. 2004; 114: 659668.[CrossRef][Medline] [Order article via Infotrieve]
60. Hasty AH, Shimano H, Osuga J, Namatame I, Takahashi A, Yahagi N, Perrey S, Iizuka Y, Tamura Y, Amemiya-Kudo M, Yoshikawa T, Okazaki H, Ohashi K, Harada K, Matsuzaka T, Sone H, Gotoda T, Nagai R, Ishibashi S, Yamada N. Severe hypercholesterolemia, hypertriglyceridemia, and atherosclerosis in mice lacking both leptin and the low density lipoprotein receptor. J Biol Chem. 2001; 276: 3740237408.
61. Kobayashi K, Forte TM, Taniguchi S, Ishida BY, Oka K, Chan L. The db/db mouse, a model for diabetic dyslipidemia: molecular characterization and effects of Western diet feeding. Metabolism. 2000; 49: 2231.[CrossRef][Medline] [Order article via Infotrieve]
62. Alp NJ, Channon KM. Regulation of endothelial nitric oxide synthase by tetrahydrobiopterin in vascular disease. Arterioscler Thromb Vasc Biol. 2004; 24: 413420.
63. Zhang YL, Hernandez-Ono A, Ko C, Yasunaga K, Huang LS, Ginsberg HN. Regulation of hepatic apolipoprotein B-lipoprotein assembly and secretion by the availability of fatty acids. I Differential response to the delivery of fatty acids via albumin or remnant-like emulsion particles. J Biol Chem. 2004; 279: 1936219374.
64. Bartels ED, Lauritsen M, Nielsen LB. Hepatic expression of microsomal triglyceride transfer protein and in vivo secretion of triglyceride-rich lipoproteins are increased in obese diabetic mice. Diabetes. 2002; 51: 12331239.
65. Nishina PM, Lowe S, Wang J, Paigen B. Characterization of plasma lipids in genetically obese mice: the mutants obese, diabetes, fat, tubby, and lethal yellow. Metabolism. 1994; 43: 549553.[CrossRef][Medline] [Order article via Infotrieve]
66. Silver DL, Jiang XC, Tall AR. Increased high density lipoprotein (HDL), defective hepatic catabolism of ApoA-I and ApoA-II, and decreased ApoA-I mRNA in ob/ob mice. Possible role of leptin in stimulation of HDL turnover. J Biol Chem. 1999; 274: 41404146.
67. Duff GL, Payne TP. The effect of alloxan diabetes on experimental cholesterol atherosclerosis in the rabbit. III The mechanism of the inhibition of experimental cholesterol atherosclerosis in alloxan-diabetic rabbits. J Exp Med. 1950; 92: 299317.
68. Duff GL, Brechin DJ, Finkelstein WE. The effect of alloxan diabetes on experimental cholesterol atherosclerosis in the rabbit. IV The effect of insulin therapy on the inhibition of atherosclerosis in the alloxan-diabetic rabbit J Exp Med. 1954; 100: 371380.
69. Nordestgaard BG, Stender S, Kjeldsen K. Reduced atherogenesis in cholesterol-fed diabetic rabbits. Giant lipoproteins do not enter the arterial wall. Arteriosclerosis. 1988; 8: 421428.
70. Nordestgaard BG, Agerholm-Larsen B, Stender S. Effect of exogenous hyperinsulinaemia on atherogenesis in cholesterol- fed rabbits. Diabetologia. 1997; 40: 512520.[CrossRef][Medline] [Order article via Infotrieve]
71. Harano Y, Kojima H, Kosugi K, Suzuki M, Harada M, Nakano T, Hidaka H, Kashiwagi A, Torii R, Taniguchi Y, et al. Hyperlipidemia and atherosclerosis in experimental insulinopenic diabetic monkeys. Diabetes Res Clin Pract. 1992; 16: 163173.[CrossRef][Medline] [Order article via Infotrieve]
72. Litwak KN, Cefalu WT, Wagner JD. Chronic hyperglycemia increases arterial low-density lipoprotein metabolism and atherosclerosis in cynomolgus monkeys. Metabolism. 1998; 47: 947954.[CrossRef][Medline] [Order article via Infotrieve]
73. Tsutsumi K, Iwamoto T, Hagi A, Kohri H. Streptozotocin-induced diabetic cynomolgus monkey is a model of hypertriglyceridemia with low high-density lipoprotein cholesterol. Biol Pharm Bull. 1998; 21: 693697.[Medline] [Order article via Infotrieve]
74. Dixon JL, Stoops JD, Parker JL, Laughlin MH, Weisman GA, Sturek M. Dyslipidemia and vascular dysfunction in diabetic pigs fed an atherogenic diet. Arterioscler Thromb Vasc Biol. 1999; 19: 29812992.
75. Gerrity RG, Natarajan R, Nadler JL, Kimsey T. Diabetes-induced accelerated atherosclerosis in swine. Diabetes. 2001; 50: 16541665.
76. Schreyer SA, Wilson DL, LeBoeuf RC. C57BL/6 mice fed high fat diets as models for diabetes-accelerated atherosclerosis. Atherosclerosis. 1998; 136: 1724.[CrossRef][Medline] [Order article via Infotrieve]
77. Haluzik M, Colombo C, Gavrilova O, Chua S, Wolf N, Chen M, Stannard B, Dietz KR, Le Roith D, Reitman ML. Genetic background (C57BL/6J versus FVB/N) strongly influences the severity of diabetes and insulin resistance in ob/ob mice. Endocrinology. 2004; 145: 32583264.
78. Kunjathoor VV, Wilson DL, LeBoeuf RC. Increased atherosclerosis in streptozotocin-induced diabetic mice. J Clin Invest. 1996; 97: 17671773.[Medline] [Order article via Infotrieve]
79. Candido R, Allen TJ, Lassila M, Cao Z, Thallas V, Cooper ME, Jandeleit-Dahm KA. Irbesartan but not amlodipine suppresses diabetes-associated atherosclerosis. Circulation. 2004; 109: 15361542.
80. Hayek T, Hussein K, Aviram M, Coleman R, Keidar S, Pavoltzky E, Kaplan M. Macrophage foam-cell formation in streptozotocin-induced diabetic mice: stimulatory effect of glucose. Atherosclerosis. 2005; 183: 2533.[CrossRef][Medline] [Order article via Infotrieve]
81. Tse J, Martin-McNaulty B, Halks-Miller M, Kauser K, DelVecchio V, Vergona R, Sullivan ME, Rubanyi GM. Accelerated atherosclerosis and premature calcified cartilaginous metaplasia in the aorta of diabetic male Apo E knockout mice can be prevented by chronic treatment with 17 beta-estradiol. Atherosclerosis. 1999; 144: 303313.[CrossRef][Medline] [Order article via Infotrieve]
82. Lyngdorf LG, Gregersen S, Daugherty A, Falk E. Paradoxical reduction of atherosclerosis in apoE-deficient mice with obesity-related type 2 diabetes. Cardiovasc Res. 2003; 59: 854862.
83. Wu KK, Wu TJ, Chin J, Mitnaul LJ, Hernandez M, Cai TQ, Ren N, Waters MG, Wright SD, Cheng K. Increased hypercholesterolemia and atherosclerosis in mice lacking both ApoE and leptin receptor. Atherosclerosis. 2005; 181: 251259.[CrossRef][Medline] [Order article via Infotrieve]
84. Gruen ML, Saraswathi V, Nuotio-Antar AM, Plummer MR, Coenen KR, Hasty AH. Plasma insulin levels predict atherosclerotic lesion burden in obese hyperlipidemic mice. Atherosclerosis. 2005.
85. Callow MJ, Verstuyft J, Tangirala R, Palinski W, Rubin EM. Atherogenesis in transgenic mice with human apolipoprotein B and lipoprotein (a). J Clin Invest. 1995; 96: 16391646.[Medline] [Order article via Infotrieve]
86. Purcell-Huynh DA, Farese RV, Jr., Johnson DF, Flynn LM, Pierotti V, Newland DL, Linton MF, Sanan DA, Young SG. Transgenic mice expressing high levels of human apolipoprotein B develop severe atherosclerotic lesions in response to a high-fat diet. J Clin Invest. 1995; 95: 22462257.[Medline] [Order article via Infotrieve]
87. Kako Y, Huang LS, Yang J, Katopodis T, Ramakrishnan R, Goldberg IJ. Streptozotocin-induced diabetes in human apolipoprotein B transgenic mice. Effects On lipoproteins and atherosclerosis. J Lipid Res. 1999; 40: 21852194.
88. Kako Y, Masse M, Huang LS, Tall AR, Goldberg IJ. Lipoprotein lipase deficiency and CETP in streptozotocin-treated apoB- expressing mice. J Lipid Res. 2002; 43: 872877.
89. Pappan KL, Pan Z, Kwon G, Marshall CA, Coleman T, Goldberg IJ, McDaniel ML, Semenkovich CF. Pancreatic beta-cell lipoprotein lipase independently regulates islet glucose metabolism and normal insulin secretion. J Biol Chem. 2005; 280: 90239029.
90. Reaven P, Merat S, Casanada F, Sutphin M, Palinski W. Effect of streptozotocin-induced hyperglycemia on lipid profiles, formation of advanced glycation endproducts in lesions, and extent of atherosclerosis in LDL receptor-deficient mice. Arterioscler Thromb Vasc Biol. 1997; 17: 22502256.
91. Schreyer SA, Vick C, Lystig TC, Mystkowski P, LeBoeuf RC. LDL receptor but not apolipoprotein E deficiency increases diet-induced obesity and diabetes in mice. Am J Physiol Endocrinol Metab. 2002; 282: E207E214.
92. Merat S, Casanada F, Sutphin M, Palinski W, Reaven PD. Western-type diets induce insulin resistance and hyperinsulinemia in LDL receptor-deficient mice but do not increase aortic atherosclerosis compared with normoinsulinemic mice in which similar plasma cholesterol levels are achieved by a fructose-rich diet. Arterioscler Thromb Vasc Biol. 1999; 19: 12231230.
93. Arai T, Wang N, Bezouevski M, Welch C, Tall AR. Decreased atherosclerosis in heterozygous low density lipoprotein receptor-deficient mice expressing the scavenger receptor BI transgene. J Biol Chem. 1999; 274: 23662371.
94. Lie J, De Crom R, Van Gent T, Van Haperen R, Scheek L, Sadeghi-Niaraki F, Van Tol. A Elevation of plasma phospholipid transfer protein increases the risk of atherosclerosis in spite of lowering apolipoprotein B containing lipoproteins. J Lipid Res. 2004.
95. Vikramadithyan RK, Hu Y, Noh HL, Liang CP, Hallam K, Tall AR, Ramasamy R, Goldberg IJ. Human aldose reductase expression accelerates diabetic atherosclerosis in transgenic mice. J Clin Invest. 2005; 115: 24342443.[CrossRef][Medline] [Order article via Infotrieve]
96. Song Z, Fu DT, Chan YS, Leung S, Chung SS, Chung SK. Transgenic mice overexpressing aldose reductase in Schwann cells show more severe nerve conduction velocity deficit and oxidative stress under hyperglycemic stress. Mol Cell Neurosci. 2003; 23: 638647.[CrossRef][Medline] [Order article via Infotrieve]
97. Yagihashi S, Yamagishi SI, Wada Ri R, Baba M, Hohman TC, Yabe-Nishimura C, Kokai Y. Neuropathy in diabetic mice overexpressing human aldose reductase and effects of aldose reductase inhibitor. Brain. 2001; 124: 24482458.
98. Lee AY, Chung SS. Contributions of polyol pathway to oxidative stress in diabetic cataract. Faseb J. 1999; 13: 2330.
99. Lee AY, Chung SK, Chung SS. Demonstration that polyol accumulation is responsible for diabetic cataract by the use of transgenic mice expressing the aldose reductase gene in the lens. Proc Natl Acad Sci U S A. 1995; 92: 27802784.
100. Ramasamy R, Oates PJ, Schaefer S. Aldose reductase inhibition protects diabetic and nondiabetic rat hearts from ischemic injury. Diabetes. 1997; 46: 292300.[Abstract]
101. Ramasamy R. Aldose reductase: a novel target for cardioprotective interventions. Curr Drug Targets. 2003; 4: 625632.[CrossRef][Medline] [Order article via Infotrieve]
102. Johnson BF, Nesto RW, Pfeifer MA, Slater WR, Vinik AI, Chyun DA, Law G, Wackers FJ, Young LH. Cardiac abnormalities in diabetic patients with neuropathy: effects of aldose reductase inhibitor administration. Diabetes Care. 2004; 27: 448454.
103. Rittner HL, Hafner V, Klimiuk PA, Szweda LI, Goronzy JJ, Weyand CM. Aldose reductase functions as a detoxification system for lipid peroxidation products in vasculitis. J Clin Invest. 1999; 103: 10071013.[Medline] [Order article via Infotrieve]
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