Palmitic acid in type 2 diabetes mellitus promotes atherosclerotic plaque vulnerability via macrophage Dll4 signaling

Nat Commun. 2024 Feb 12;15(1):1281. doi: 10.1038/s41467-024-45582-8.

Abstract

Patients with Type 2 Diabetes Mellitus are increasingly susceptible to atherosclerotic plaque vulnerability, leading to severe cardiovascular events. In this study, we demonstrate that elevated serum levels of palmitic acid, a type of saturated fatty acid, are significantly linked to this enhanced vulnerability in patients with Type 2 Diabetes Mellitus. Through a combination of human cohort studies and animal models, our research identifies a key mechanistic pathway: palmitic acid induces macrophage Delta-like ligand 4 signaling, which in turn triggers senescence in vascular smooth muscle cells. This process is critical for plaque instability due to reduced collagen synthesis and deposition. Importantly, our findings reveal that macrophage-specific knockout of Delta-like ligand 4 in atherosclerotic mice leads to reduced plaque burden and improved stability, highlighting the potential of targeting this pathway. These insights offer a promising direction for developing therapeutic strategies to mitigate cardiovascular risks in patients with Type 2 Diabetes Mellitus.

MeSH terms

  • Animals
  • Apolipoproteins E / metabolism
  • Diabetes Mellitus, Type 2* / metabolism
  • Disease Models, Animal
  • Humans
  • Macrophages / metabolism
  • Mice
  • Mice, Knockout
  • Myocytes, Smooth Muscle / metabolism
  • Palmitic Acid / metabolism
  • Plaque, Atherosclerotic* / metabolism

Substances

  • Apolipoproteins E
  • Palmitic Acid
  • DLL4 protein, human
  • DLL4 protein, mouse