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Potential biomarkers of insulin resistance and atherosclerosis in type 2 diabetes mellitus patients with coronary artery disease.

Syed Ikmal SI, Zaman Huri H, Vethakkan SR, Wan Ahmad WA - Int J Endocrinol (2013)

Bottom Line: The combination of insulin resistance and endothelial dysfunction leads to coronary artery disease and ischemic heart disease complications.Malfunctioning of insulin mechanism and endothelial dysfunction leads to innate immune activation and released several biological markers into circulation.This review examines potential biological markers, YKL-40, alpha-hydroxybutyrate, soluble CD36, leptin, resistin, interleukin-18, retinol binding protein-4, and chemerin, as they may play significant roles in insulin resistance and atherosclerosis in type 2 diabetes mellitus patients with coronary artery disease.

View Article: PubMed Central - PubMed

Affiliation: Department of Pharmacy, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia.

ABSTRACT
Type 2 diabetes mellitus patients with coronary artery disease have become a major public health concern. The occurrence of insulin resistance accompanied with endothelial dysfunction worsens the state of atherosclerosis in type 2 diabetes mellitus patients. The combination of insulin resistance and endothelial dysfunction leads to coronary artery disease and ischemic heart disease complications. A recognized biological marker, high-sensitivity C-reactive protein, has been used widely to assess the progression of atherosclerosis and inflammation. Along with coronary arterial damage and inflammatory processes, high-sensitivity C-reactive protein is considered as an essential atherosclerosis marker in patients with cardiovascular disease, but not as an insulin resistance marker in type 2 diabetes mellitus patients. A new biological marker that can act as a reliable indicator of both the exact state of insulin resistance and atherosclerosis is required to facilitate optimal health management of diabetic patients. Malfunctioning of insulin mechanism and endothelial dysfunction leads to innate immune activation and released several biological markers into circulation. This review examines potential biological markers, YKL-40, alpha-hydroxybutyrate, soluble CD36, leptin, resistin, interleukin-18, retinol binding protein-4, and chemerin, as they may play significant roles in insulin resistance and atherosclerosis in type 2 diabetes mellitus patients with coronary artery disease.

No MeSH data available.


Related in: MedlinePlus

Mechanism of insulin resistance, endothelial dysfunction and proinflammatory secretion.
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Related In: Results  -  Collection


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fig1: Mechanism of insulin resistance, endothelial dysfunction and proinflammatory secretion.

Mentions: At a basic level, insulin resistance occurs through the activation of various types of macrophages. Malfunctioning adipocytes and adipose tissue release greater amounts of various proinflammatory cytokines. Subclinical inflammation due to insulin resistance might also correlate with the pathogenesis of all phases of atherosclerosis. This involves low-grade elevation of acute phase reactants, proinflammatory cytokine secretion, and cell adhesion molecules and leads to myocardial infarction, stroke, and other major peripheral vascular diseases. These factors, therefore, increase cardiovascular mortality. Activation of the innate immune system greatly contributes to the occurrence of T2DM and CAD (Figure 1) [9].


Potential biomarkers of insulin resistance and atherosclerosis in type 2 diabetes mellitus patients with coronary artery disease.

Syed Ikmal SI, Zaman Huri H, Vethakkan SR, Wan Ahmad WA - Int J Endocrinol (2013)

Mechanism of insulin resistance, endothelial dysfunction and proinflammatory secretion.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3824310&req=5

fig1: Mechanism of insulin resistance, endothelial dysfunction and proinflammatory secretion.
Mentions: At a basic level, insulin resistance occurs through the activation of various types of macrophages. Malfunctioning adipocytes and adipose tissue release greater amounts of various proinflammatory cytokines. Subclinical inflammation due to insulin resistance might also correlate with the pathogenesis of all phases of atherosclerosis. This involves low-grade elevation of acute phase reactants, proinflammatory cytokine secretion, and cell adhesion molecules and leads to myocardial infarction, stroke, and other major peripheral vascular diseases. These factors, therefore, increase cardiovascular mortality. Activation of the innate immune system greatly contributes to the occurrence of T2DM and CAD (Figure 1) [9].

Bottom Line: The combination of insulin resistance and endothelial dysfunction leads to coronary artery disease and ischemic heart disease complications.Malfunctioning of insulin mechanism and endothelial dysfunction leads to innate immune activation and released several biological markers into circulation.This review examines potential biological markers, YKL-40, alpha-hydroxybutyrate, soluble CD36, leptin, resistin, interleukin-18, retinol binding protein-4, and chemerin, as they may play significant roles in insulin resistance and atherosclerosis in type 2 diabetes mellitus patients with coronary artery disease.

View Article: PubMed Central - PubMed

Affiliation: Department of Pharmacy, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia.

ABSTRACT
Type 2 diabetes mellitus patients with coronary artery disease have become a major public health concern. The occurrence of insulin resistance accompanied with endothelial dysfunction worsens the state of atherosclerosis in type 2 diabetes mellitus patients. The combination of insulin resistance and endothelial dysfunction leads to coronary artery disease and ischemic heart disease complications. A recognized biological marker, high-sensitivity C-reactive protein, has been used widely to assess the progression of atherosclerosis and inflammation. Along with coronary arterial damage and inflammatory processes, high-sensitivity C-reactive protein is considered as an essential atherosclerosis marker in patients with cardiovascular disease, but not as an insulin resistance marker in type 2 diabetes mellitus patients. A new biological marker that can act as a reliable indicator of both the exact state of insulin resistance and atherosclerosis is required to facilitate optimal health management of diabetic patients. Malfunctioning of insulin mechanism and endothelial dysfunction leads to innate immune activation and released several biological markers into circulation. This review examines potential biological markers, YKL-40, alpha-hydroxybutyrate, soluble CD36, leptin, resistin, interleukin-18, retinol binding protein-4, and chemerin, as they may play significant roles in insulin resistance and atherosclerosis in type 2 diabetes mellitus patients with coronary artery disease.

No MeSH data available.


Related in: MedlinePlus