Type 2 diabetes as an inflammatory cardiovascular disorder

Curr Mol Med. 2005 May;5(3):309-22. doi: 10.2174/1566524053766095.

Abstract

Type 2 diabetes carries a 2-6-fold increased risk of cardiovascular disease (CVD) and death. Indeed, the risk of major cardiovascular events in Type 2 diabetic patients without history of coronary heart disease (CHD) is equivalent to that observed in non-diabetic subjects with CHD. However, atherosclerosis may also precede the development of diabetes, suggesting that both disorders share common genetic and environmental antecedent factors ("common soil" hypothesis). One such a possible ancestor is insulin resistance which constitutes both a major feature of Type 2 diabetes and an independent risk factor for CHD. It is well documented that inflammatory processes play an important role in the causation of atherosclerotic CVD. Inflammatory mediators play a paramount role in the initiation, progression, and rupture of atherosclerotic plaques. Thus, markers of inflammation and endothelial dysfunction may provide additional information about a patient's risk of developing CVD and may become new targets for treatment. On the other hand, evidence has emerged suggesting that inflammation is also involved in the development of Type 2 diabetes. Prospective studies have demonstrated that increased levels of pro-inflammatory markers such as CRP or reduced levels of anti-inflammatory markers such as adiponectin predict the development of Type 2 diabetes. Thus, there is accumulating evidence suggesting that inflammation is the bridging link between atherosclerosis and the metabolic syndrome. Interventions by lifestyle modification or agents with anti-inflammatory properties may reduce the risk of both conditions. Drugs exerting anti-inflammatory and vascular effects have future potential to be used within an array of interventions aimed at reducing the enormous cardiovascular burden associated with Type 2 diabetes.

Publication types

  • Review

MeSH terms

  • Adiponectin
  • Animals
  • Anti-Inflammatory Agents / pharmacology
  • Arteriosclerosis / diagnosis*
  • Arteriosclerosis / pathology
  • Cardiovascular Diseases / diagnosis*
  • Cardiovascular Diseases / metabolism
  • Diabetes Complications / metabolism
  • Diabetes Mellitus, Type 2 / diagnosis*
  • Diabetes Mellitus, Type 2 / metabolism
  • Disease Progression
  • Endothelium, Vascular / metabolism
  • Humans
  • Inflammation / metabolism
  • Insulin Resistance
  • Intercellular Signaling Peptides and Proteins / metabolism
  • Leukocytes / metabolism
  • Prospective Studies
  • Thiazolidinediones / pharmacology

Substances

  • Adiponectin
  • Anti-Inflammatory Agents
  • Intercellular Signaling Peptides and Proteins
  • Thiazolidinediones
  • 2,4-thiazolidinedione