Obesity, Glucose Intolerance and Diabetes and Their Links to Cardiovascular Disease. Implications for Laboratory Medicine
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Marek H. Dominiczak
Abstract
This article provides an overview of the role of metabolite toxicity, low-grade inflammation and disturbed cellular signaling in obesity, glucose intolerance and diabetes. It also highlights links between this continuum of deteriorating glucose tolerance and atherosclerosis.
Obesity, diabetes mellitus, and cardiovascular disease are all related to diet and to the level of physical activity. They have reached epidemic proportions worldwide. Glucose intolerance and diabetes increase the risk of atherosclerotic events. Moreover, obesity, and glucose intolerance or diabetes, are components of the metabolic syndrome, which also imparts an increased cardiovascular risk. There is increasing recognition that common mechanisms contribute to diabetes and cardiovascular disease. Following increased calorie intake and/or decreased physical activity, fuel metabolism generates excess of ‘toxic’ metabolites, particularly glucose and fatty acids. Homeostasis is affected by the endocrine output from the adipose tissue. Reactive oxygen species are generated, creating oxidative stress, which exerts major effects on signaling pathways, further affecting cellular metabolism and triggering low-grade inflammatory reaction.
This perspective on the diabetic syndrome has been reflected in the approach to its treatment, which integrates maintenance of glycemic control with primary and secondary cardiovascular prevention. Laboratory medicine should support diabetes care with an integrated package of tests which, in addition to glycemic control, enable assessment and monitoring of the risk of microvascular complications as well as cardiovascular disease.
Copyright © 2003 by Walter de Gruyter GmbH & Co. KG
Articles in the same Issue
- Editors' Introduction: Welcome to the Special Issue on Diabetes Mellitus
- Linking Research and Innovative Clinical Practice: The Story of Diabetes Mellitus
- Insulin Resistant States and Insulin Signaling
- Diabesity: An Inflammatory Metabolic Condition
- Plasma Adiponectin and Hyperglycaemia in Diabetic Patients
- Platelet Function and Acetyl-Coenzyme A Metabolism in Type 1 Diabetes Mellitus
- Oxidative Stress in Diabetes
- Carbonyl Stress and Diabetic Complications
- Chemical Modification of Proteins by Lipids in Diabetes
- Glyoxal and Methylglyoxal Levels in Diabetic Patients: Quantitative Determination by a New GC/MS Method
- Dyslipidemia in Patients with Type 2 Diabetes. Relationships between Lipids, Kidney Disease and Cardiovascular Disease
- Haemoglobin A1c – A Marker for Complications of Type 2 Diabetes: The Experience from the UK Prospective Diabetes Study (UKPDS)
- Glycated Hemoglobin Standardization – National Glycohemoglobin Standardization Program (NGSP) Perspective
- Haemoglobin A1c: Analysis and Standardisation
- Point-of-Care Testing in Diabetes Mellitus
- Evaluation of Portable Blood Glucose Meters. Problems and Recommendations
- Measurements of Glucose on the Skin Surface, in Stratum Corneum and in Transcutaneous Extracts: Implications for Physiological Sampling
- Biological Variability of Albumin Excretion Rate and Albumin-to-Creatinine Ratio in Hypertensive Type 2 Diabetic Patients
- Clinical and Laboratory Evaluation of Specific Chemiluminescence Assays for Intact and Total Proinsulin
- Clinical Impact of the New Criteria for the Diagnosis of Diabetes Mellitus
- The Effect of the New ADA and WHO Guidelines on the Number of Diagnosed Cases of Diabetes Mellitus
- Detecting Type 2 Diabetes by a Single Post-Challenge Blood Sample
- Laboratory Tests in Diagnosis and Management of Diabetes Mellitus. Practical Considerations
- Obesity, Glucose Intolerance and Diabetes and Their Links to Cardiovascular Disease. Implications for Laboratory Medicine
- Meetings and Awards
Articles in the same Issue
- Editors' Introduction: Welcome to the Special Issue on Diabetes Mellitus
- Linking Research and Innovative Clinical Practice: The Story of Diabetes Mellitus
- Insulin Resistant States and Insulin Signaling
- Diabesity: An Inflammatory Metabolic Condition
- Plasma Adiponectin and Hyperglycaemia in Diabetic Patients
- Platelet Function and Acetyl-Coenzyme A Metabolism in Type 1 Diabetes Mellitus
- Oxidative Stress in Diabetes
- Carbonyl Stress and Diabetic Complications
- Chemical Modification of Proteins by Lipids in Diabetes
- Glyoxal and Methylglyoxal Levels in Diabetic Patients: Quantitative Determination by a New GC/MS Method
- Dyslipidemia in Patients with Type 2 Diabetes. Relationships between Lipids, Kidney Disease and Cardiovascular Disease
- Haemoglobin A1c – A Marker for Complications of Type 2 Diabetes: The Experience from the UK Prospective Diabetes Study (UKPDS)
- Glycated Hemoglobin Standardization – National Glycohemoglobin Standardization Program (NGSP) Perspective
- Haemoglobin A1c: Analysis and Standardisation
- Point-of-Care Testing in Diabetes Mellitus
- Evaluation of Portable Blood Glucose Meters. Problems and Recommendations
- Measurements of Glucose on the Skin Surface, in Stratum Corneum and in Transcutaneous Extracts: Implications for Physiological Sampling
- Biological Variability of Albumin Excretion Rate and Albumin-to-Creatinine Ratio in Hypertensive Type 2 Diabetic Patients
- Clinical and Laboratory Evaluation of Specific Chemiluminescence Assays for Intact and Total Proinsulin
- Clinical Impact of the New Criteria for the Diagnosis of Diabetes Mellitus
- The Effect of the New ADA and WHO Guidelines on the Number of Diagnosed Cases of Diabetes Mellitus
- Detecting Type 2 Diabetes by a Single Post-Challenge Blood Sample
- Laboratory Tests in Diagnosis and Management of Diabetes Mellitus. Practical Considerations
- Obesity, Glucose Intolerance and Diabetes and Their Links to Cardiovascular Disease. Implications for Laboratory Medicine
- Meetings and Awards
