Diabetes and Vascular Disease. Pathophysiology, Clinical Consequences, and Medical Therapy Part I.pdf

文档介绍：Review: Clinical Cardiology: New Frontiers
Diabetes and Vascular Disease
Pathophysiology, Clinical Consequences, and Medical Therapy: Part I
Mark A. Creager, MD; Thomas F. Lüscher, MD, FRCP; and prepared with the assistance of
Francesco Cosentino, MD, PhD; Joshua A. Beckman, MD
iabetes mellitus affects approximately 100 million per- In addition, NO protects the blood vessel from endog-
Dsons Five to ten percent have type 1 enous injury—ie, atherosclerosis—by mediating molecular
(formerly known as insulin-dependent) and 90% to 95% have signals that prevent platelet and leukocyte interaction with the
type 2 (non–insulin-dependent) diabetes mellitus. It is likely vascular wall and inhibit vascular smooth muscle cell prolif-
that the incidence of type 2 diabetes will rise as a conse- eration and –7 Conversely, the loss of endotheli-
quence of lifestyle patterns contributing to Cardio- um-derived NO permits increased activity of the proinflam-
vascular physicians are encountering many of these patients matory transcription factor nuclear factor kappa B (NF-␬〉),
because vascular diseases are the principal causes of death resulting in expression of leukocyte adhesion molecules and
and disability in people with diabetes. The macrovascular production of chemokines and These actions
manifestations include atheroscler