The Role of Diabetes Mellitus in the Occurrence and Development of Endothelial Dysfunction

Abstract

The vascular endothelium performs many functions. It is a key regulator of vascular homeostasis, maintaining the balance between vasodilation and vasoconstriction, inhibition and stimulation of smooth muscle cell migration and proliferation, fibrinolysis and thrombus formation, and is also involved in the regulation of platelet adhesion and aggregation. Endothelial dysfunction underlies the pathogenesis of vascular complications of diabetes mellitus. The purpose of this review was to examine the mechanisms leading to endothelial dysfunction in diabetes mellitus. The work examines current literature data concerning the role of hyperglycemia, oxidative stress, and advanced glycation end products in endothelial alteration. A separate section is devoted to the peculiarities of the functioning of the antioxidant system and their significance in the development of endothelial dysfunction in diabetes mellitus. The analysis of the literature allows us to conclude that in diabetes mellitus, pathological activation of glucose utilization pathways causes damage to endothelial cells, which is accompanied by a violation of all their main functions. Metabolic disorders in diabetes mellitus cause a pronounced imbalance of free radical processes and antioxidant defense, accompanied by oxidative stress of endothelial cells, which contributes to the progression of endothelial dysfunction and the development of vascular complications. Many aspects of multicomponent regulatory reactions in the pathogenesis of the development of endothelial dysfunction in diabetes mellitus have not yet been sufficiently studied.