C-Peptide in the Vessel Wall
Daniel Walcher
Department of Internal Medicine II, Cardiology, University of Ulm, GermanyNikolaus Marx
Department of Internal Medicine I, Cardiology, University of Aachen, GermanyAbstract:
Patients with insulin resistance and early type 2 diabetes exhibit an increased sensitivity to develop a diffuse and extensive pattern of arteriosclerosis leading to a remarkable increase in vascular complications, including myocardial infarction and stroke. The accelerated atherosclerosis in these patients is likely to be multifactorial. In this review, we introduce the new hypothesis that C-peptide could play a role as a mediator of lesion development. Patients with type 2 diabetes show increased levels of the proinsulin cleavage product C-peptide, and in the past few years, various groups have examined the effect of C-peptide in vascular cells as well as its potential role in lesion development. Recent data suggest that C-peptide deposits in the vessel wall could promote the recruitment of monocytes and CD4-positive lymphocytes in early arteriosclerotic lesions. Furthermore, C-peptide induces proliferation of vascular smooth muscle cells, a critical step in atherogenesis and restenosis formation. The present review summarizes this new pathophysiological aspect and discusses the potential relevance for lesion development.
Keywords
diabetes · C-peptide · vascular cell · arteriosclerosis · inflammation · reactive oxygen species · smooth muscle cell · lipoprotein,.Editor
MD, PhD
Abbreviation Title
Rev Diabet Stud