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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

Insulin resistance in T2DM and endothelial dysfunction in CAD development.
© Copyright Policy - open-access
Related In: Results  -  Collection


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fig2: Insulin resistance in T2DM and endothelial dysfunction in CAD development.

Mentions: A common mechanism of endothelium dysfunction is the depletion of eNOS. According to Willa and Manuel 2003, prolonged decreases of eNOS lead to decreased bioavailability of nitric oxide (NO), which acts as vascular protection by inhibiting inflammation, oxidation, vascular smooth muscle cell proliferation, and migration [14]. Decreased bioavailability of NO, along with low levels of high-density lipoprotein, high levels of small, dense, low-density lipoprotein, high secretion of angiotensin II sensitivity, and high releases of FFA in the blood, worsen is the status of endothelial dysfunction and promotes further atherogenic processes [14]. In addition, the effects of inflammation and reactive oxygen species contribute to decreasing NO bioavailability and stimulate secretion of proinflammatory cytokines, which are termed as possible biomarkers. Identification of these biomarkers might serve as tools for predicting insulin resistance and endothelial dysfunction in T2DM patients with CAD (Figure 2) [14].


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)

Insulin resistance in T2DM and endothelial dysfunction in CAD development.
© Copyright Policy - open-access
Related In: Results  -  Collection

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

fig2: Insulin resistance in T2DM and endothelial dysfunction in CAD development.
Mentions: A common mechanism of endothelium dysfunction is the depletion of eNOS. According to Willa and Manuel 2003, prolonged decreases of eNOS lead to decreased bioavailability of nitric oxide (NO), which acts as vascular protection by inhibiting inflammation, oxidation, vascular smooth muscle cell proliferation, and migration [14]. Decreased bioavailability of NO, along with low levels of high-density lipoprotein, high levels of small, dense, low-density lipoprotein, high secretion of angiotensin II sensitivity, and high releases of FFA in the blood, worsen is the status of endothelial dysfunction and promotes further atherogenic processes [14]. In addition, the effects of inflammation and reactive oxygen species contribute to decreasing NO bioavailability and stimulate secretion of proinflammatory cytokines, which are termed as possible biomarkers. Identification of these biomarkers might serve as tools for predicting insulin resistance and endothelial dysfunction in T2DM patients with CAD (Figure 2) [14].

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