scholarly journals Microvascular and Macrovascular Complications of Diabetes

2008 ◽  
Vol 26 (2) ◽  
pp. 77-82 ◽  
Author(s):  
M. J. Fowler
Keyword(s):  
Macrovascular Complications ◽  
Complications Of Diabetes ◽  
Microvascular And Macrovascular Complications

A Review on Cellular and Molecular Mechanisms Linked to the Development of Diabetes Complications

2020 ◽  
Vol 16 ◽  
Author(s):  
Rishabh A. Babel ◽  
Manoj P. Dandekar
Keyword(s):  
Oxidative Stress ◽  
Molecular Mechanisms ◽  
Microvascular Complications ◽  
Macrovascular Complications ◽  
Physical Work ◽  
Complications Of Diabetes ◽  
Chronic Hyperglycemia ◽  
Hexosamine Pathway ◽  
Artery Disease ◽  
Microvascular And Macrovascular Complications

: Modern lifestyle, changing eating habits and reduced physical work have been known to culminate into making diabetes a global pandemic. Hyperglycemia during the course of diabetes is an important causative factor for the development of both microvascular (retinopathy, nephropathy and neuropathy) and macrovascular (coronary artery disease, stroke and peripheral artery disease) complications. In this article, we summarize several mechanisms accountable for the development of both microvascular and macrovascular complications of diabetes. Several metabolic and cellular events are linked to the augmentation of oxidative stress like the activation of advanced glycation endproducts (AGE) pathway, polyol pathway, protein kinase C (PKC) pathway, poly-ADP ribose polymerase (PARP) and hexosamine pathway. Oxidative stress also leads to production of reactive oxygen species (ROS) like hydroxyl radical, superoxide anion and peroxides. Enhanced levels of ROS rescind the anti-oxidant defence mechanisms associated with superoxide dismutase, glutathione and ascorbic acid. Moreover, ROS triggers oxidative damages at the level of DNA, protein and lipids which eventually cause cell necrosis or apoptosis. These physiological insults may be related to the microvascular complications of diabetes by negatively impacting the eyes, kidneys and brain. While underlying pathomechanism of the macrovascular complications is quite complex, hyperglycemia associated atherosclerotic abnormalities like changes in the coagulation system, thrombin formation, fibrinolysis, platelet and endothelial function and vascular smooth muscle is well proven. Since hyperglycemia also modulates the vascular inflammation, cytokines, macrophage activation and gene expression of growth factors, elevated blood glucose level may play a central role in the development of macrovascular complications of diabetes. Taken collectively, chronic hyperglycemia and increased production of ROS are the miscreants for the development of microvascular and macrovascular complications of diabetes.

scholarly journals Role of fructosamine-3-kinase in protecting against the onset of microvascular and macrovascular complications in patients with T2DM

2020 ◽  
Vol 8 (1) ◽  
pp. e001256
Author(s):  
Giovanni Sartore ◽  
Eugenio Ragazzi ◽  
Silvia Burlina ◽  
Renata Paleari ◽  
Nino Cristiano Chilelli ◽  
...  
Keyword(s):  
Enzymatic Activity ◽  
Biochemical Parameters ◽  
Protective Role ◽  
Macrovascular Complications ◽  
Protein Glycation ◽  
Complications Of Diabetes ◽  
History Of ◽  
Design And Methods ◽  
Microvascular And Macrovascular Complications

IntroductionMicroangiopathic and macroangiopathic complications are the main cause of morbidity and mortality in the diabetic population. Numerous publications have highlighted the role of glycation in the onset of complications of diabetes. In this context, the detection of fructosamine-3-kinase (FN3K)—an enzyme capable of counteracting the effect of hyperglycemia by intervening in protein glycation—has attracted great interest. Several studies have linked FN3K genetic variability to its enzymatic activity and glycated hemoglobin (HbA1c) levels. Here, we investigated the role of FN3K polymorphisms in the development of microvascular and macrovascular complications of diabetes.Research design and methodsThe anthropometric and biochemical parameters, and any medical history of microangiopathic and macroangiopathic complications, were documented in a sample of 80 subjects with type 2 diabetes. All subjects were screened for FN3K gene and analyzed for the combination of three polymorphisms known to be associated with its enzymatic activity (rs3859206 and rs2256339 in the promoter region and rs1056534 in exon 6).ResultsThe combination of allelic variants of FN3K polymorphisms resulted in 13 distinct genotypic variants within the cohort. Comparison between genotypes showed no significant differences in terms of demographic, anthropometric and biochemical parameters, risk markers and long-term complications, except for a higher age and vitamin E levels associated with the genotype presenting GG at position −385, TT at position −232, and CC at c.900 A. Evaluating the microangiopathic and macroangiopathic complications as a whole, we found that they appeared significantly less present in this genotype compared with all other genotypes (p=0.0306).ConclusionsThe group of patients carrying the favorable allele for the three polymorphisms of the FN3K gene revealed less severe microangiopathy and macroangiopathy, suggesting a protective role of this genotype against the onset of the complications of diabetes.

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