Arterioscler Thromb Vasc Biol. 2004 Feb 19 [Epub ahead of print] Related
Articles, Links
Is Oxidative Stress the Pathogenic Mechanism Underlying Insulin Resistance,
Diabetes, and Cardiovascular Disease? The Common Soil Hypothesis Revisited.
Ceriello A, Motz E.
Department of Pathology and Medicine, Experimental and Clinical, University of
Udine, Italy.
Type 2 diabetes is a worldwide increasing disease resulting from the
interaction between a subject's genetic makeup and lifestyle. In genetically
predisposed subjects, the combination of excess caloric intake and reduced
physical activity induces a state of insulin resistance. When beta cells are no
longer able to compensate for insulin resistance by adequately increasing
insulin production, impaired glucose tolerance appears, characterized by
excessive postprandial hyperglycemia. Impaired glucose tolerance may evolve
into overt diabetes. These 3 conditions, ie, insulin resistance, impaired
glucose tolerance, and overt diabetes, are associated with an increased risk of
cardiovascular disease. Because all these conditions are also accompanied by
the presence of an oxidative stress, this article proposes oxidative stress as
the pathogenic mechanism linking insulin resistance with dysfunction of both
beta cells and endothelium, eventually leading to overt diabetes and
cardiovascular disease. This hypothesis, moreover, may also contribute to
explaining why treating cardiovascular risk with drugs, such as calcium channel
blockers, ACE inhibitors, AT-1 receptor antagonists, and statins, all compounds
showing intracellular preventive antioxidant activity, results in the onset of
new cases of diabetes possibly being reduced.
PMID: 14976002 [PubMed - as supplied by publisher]
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