Review Article

Macrovascular Complications in Patients with Diabetes and Prediabetes

Figure 1

The effect of insulin resistance and hyperglycemia in CVD pathogenesis. Insulin resistance is tightly correlated with obesity, which increases FFA and ROS level, both of which contribute to atherosclerotic changes and the development of macrovascular complications. Increased plasma glucose level contributes to increased production of ROS as well, which activates PKCs intracellularly and leads to inflammatory changes and atherosclerosis. FFAs: free fatty acids, ROS: reactive oxygen species, TLR: Toll-like receptor, PI3K: PI3-kinase, PKC: protein kinase C, eNOS: endothelial nitric oxide synthase, NO: nitric oxide, COX-2: cyclooxygenase-2, TXA2: thromboxane A2, : prostacyclin, ET-1: endothelin-1.