Eberhard Standl Pages 678 - 679 ( 2 )
Dysglycemia as a pre-stage of diabetes mellitus and abdominal obesity are closely interrelated at multiple levels and by a whole array of complex mechanisms, many of which seem to have the potential of causing harm to large blood vessels, in particular to coronary and peripheral vascular segments. Both conditions are associated with elevated circulating concentrations of free fatty acids in conjunction with insulin resistance, oxidative stress, mitochondrial dysfunction, disordered nitric oxide release, and endothelial dysfunction. Oscillating glucose levels seem to be associated with the most of the injury burden to endothelial cells of large blood vessels and also generate some kind of metabolic memory. In addition, the multiple effects of insulin also on the regulation of the vasculature are shifted towards vasoconstriction and proliferation in the context of insulin resistance and the excessively high levels.
Dysglycemia, diabetes mellitus, abdominal obesity, peripheral vascular disease, coronary heart disease
Munich Diabetes Research Group, Helmholtz Centre Munich-Neuherberg, Ingolstaedter Landstrasse 1, D-85764 Neuherberg, Germany.