Pathology of Human Coronary and Carotid Artery Atherosclerosis and Vascular Calcification in Diabetes Mellitus
Top Cited Papers
- 1 February 2017
- journal article
- review article
- Published by Ovid Technologies (Wolters Kluwer Health) in Arteriosclerosis, Thrombosis, and Vascular Biology
- Vol. 37 (2), 191-204
- https://doi.org/10.1161/atvbaha.116.306256
Abstract
The continuing increase in the prevalence of diabetes mellitus in the general population is predicted to result in a higher incidence of cardiovascular disease. Although the mechanisms of diabetes mellitus–associated progression of atherosclerosis are not fully understood, at clinical and pathological levels, there is an appreciation of increased disease burden and higher levels of arterial calcification in these subjects. Plaques within the coronary arteries of patients with diabetes mellitus generally exhibit larger necrotic cores and significantly greater inflammation consisting mainly of macrophages and T lymphocytes relative to patients without diabetes mellitus. Moreover, there is a higher incidence of healed plaque ruptures and positive remodeling in hearts from subjects with type 1 diabetes mellitus and type 2 diabetes mellitus, suggesting a more active atherogenic process. Lesion calcification in the coronary, carotid, and other arterial beds is also more extensive. Although the role of coronary artery calcification in identifying cardiovascular disease and predicting its outcome is undeniable, our understanding of how key hormonal and physiological alterations associated with diabetes mellitus such as insulin resistance and hyperglycemia influence the process of vascular calcification continues to grow. Important drivers of atherosclerotic calcification in diabetes mellitus include oxidative stress, endothelial dysfunction, alterations in mineral metabolism, increased inflammatory cytokine production, and release of osteoprogenitor cells from the marrow into the circulation. Our review will focus on the pathophysiology of type 1 diabetes mellitus– and type 2 diabetes mellitus–associated vascular disease with particular focus on coronary and carotid atherosclerotic calcification.Keywords
This publication has 113 references indexed in Scilit:
- Activation of nuclear factor-kappa B accelerates vascular calcification by inhibiting ankylosis protein homolog expressionKidney International, 2012
- Arterial Calcification in Chronic Kidney Disease: Key Roles for Calcium and PhosphateCirculation Research, 2011
- Fibroblast Growth Factor 23 and Risks of Mortality and End-Stage Renal Disease in Patients With Chronic Kidney DiseaseJAMA, 2011
- Runx2-Upregulated Receptor Activator of Nuclear Factor κB Ligand in Calcifying Smooth Muscle Cells Promotes Migration and Osteoclastic Differentiation of MacrophagesArteriosclerosis, Thrombosis, and Vascular Biology, 2011
- S100A12 in Vascular Smooth Muscle Accelerates Vascular Calcification in Apolipoprotein E–Null Mice by Activating an Osteogenic Gene Regulatory ProgramArteriosclerosis, Thrombosis, and Vascular Biology, 2011
- Diabetes mellitus, fasting blood glucose concentration, and risk of vascular disease: a collaborative meta-analysis of 102 prospective studiesThe Lancet, 2010
- 10-Year Follow-up of Intensive Glucose Control in Type 2 DiabetesNew England Journal of Medicine, 2008
- Fibroblast Growth Factor 23 and Mortality among Patients Undergoing HemodialysisNew England Journal of Medicine, 2008
- Effects of Intensive Glucose Lowering in Type 2 DiabetesNew England Journal of Medicine, 2008
- Spontaneous calcification of arteries and cartilage in mice lacking matrix GLA proteinNature, 1997