Is type 2 diabetes mellitus a vascular disease (atheroscleropathy) with hyperglycemia a late manifestation? The role of NOS, NO, and redox stress
Is type 2 diabetes mellitus a vascular disease (atheroscleropathy) with hyperglycemia a late manifestation? The role of NOS, NO, and redox stress
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DOI：
10.1186/1475-2840-2-2
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发表时间：
2003-01-01
影响因子：
9.3
通讯作者：
Tyagi, Suresh C.
中科院分区：
文献类型：
--
作者：
Hayden, Melvin R.;Tyagi, Suresh C.
背景：心血管疾病至少占2型糖尿病（T2 DM）患者死亡的85%。假设：2型糖尿病是一种血管疾病（动脉粥样硬化），高血糖是晚期表现吗？一氧化氮合酶、一氧化氮和氧化还原应激的作用。假设的检验：eNOS反应的脆弱的三个臂负责产生eNO的讨论与假设有关：（1）。L-精氨酸底物（二）、eNOS酶。（三）、BH 4辅助因子：假设的意义：如果我们将T2 DM视为一种最初表现为高血糖的血管疾病，我们可能能够更好地理解和改变与胰岛素抵抗、代谢综合征、前驱糖尿病、显性T2 DM和加速动脉粥样硬化（动脉粥样硬化病）相关的多种毒性。内皮型一氧化氮合酶，内皮型一氧化氮，四氢生物蝶呤（BH 4），L-精氨酸，氧化还原应激的重要性进行了讨论，内皮细胞功能障碍和动脉粥样硬化和2型糖尿病的发展和进展。除了恢复内皮细胞功能障碍和稳定脆弱的动脉粥样硬化斑块的标准治疗外，本文将讨论叶酸（5 MTHF）补充在这一复杂的破坏性疾病过程中的重要性。动脉粥样硬化和高血糖可能分别是T2 DM自然进展史的早期和晚期表现。
Background: Cardiovascular disease accounts for at least 85 percent of deaths for those patients with type 2 diabetes mellitus (T2DM). Additionally, 75 percent of these deaths are due to ischemic heart disease.Hypothesis: Is type 2 diabetes mellitus a vascular disease (atheroscleropathy) with hyperglycemia a late manifestation? The role of NOS, NO, and redox stress.Testing of the hypothesis: The vulnerable three arms of the eNOS reaction responsible for the generation of eNO is discussed in relation to the hypothesis: (1). The L-arginine substrate. (2). The eNOS enzyme. (3). The BH4 cofactor.Implications of the hypothesis: If we view T2DM as a vascular disease initially with a later manifestation of hyperglycemia, we may be able to better understand and modify the multiple toxicities associated with insulin resistance, metabolic syndrome, prediabetes, overt T2DM, and accelerated atherosclerosis (atheroscleropathy). The importance of endothelial nitric oxide synthase, endothelial nitric oxide, tetrahydrobiopterin (BH4), L-arginine, and redox stress are discussed in relation to endothelial cell dysfunction and the development and progression of atheroscleropathy and T2DM. In addition to the standard therapies to restore endothelial cell dysfunction and stabilization of vulnerable atherosclerotic plaques, this article will discuss the importance of folic acid (5MTHF) supplementation in this complex devastating disease process.Atheroscleropathy and hyperglycemia could be early and late manifestations, respectively, in the natural progressive history of T2DM.