This review highlights the molecular mechanisms linking diabetes mellitus, dyslipidemia, and increased risk for atherosclerotic vascular disease, noting the roles of sphingosine-1-phosphate and ceramides.
S1P pathway merits exploration across diabetic subphenotypes; hypothesis-generating and should not yet change practice.
Diabetes mellitus is a complex disease. We are increasingly gaining a better understanding of its mechanisms at the molecular level. From these new insights, better therapeutic approaches should emerge. Diabetes mellitus is a syndrome with many associated subphenotypes. These include mitochondrial disorders, lipodystrophies, and inflammatory disorders involving cytokines. Levels of sphingosine-1-phosphate, which has recently been shown to play a role in glucose homeostasis, are low in diabetics, whereas levels of ceramides are increased. Major phenotypes associated with diabetes mellitus are dyslipidemias, notably hypertriglyceridemia and low high-density lipoprotein cholesterol levels. Both diabetes and dyslipidemia are strongly associated with increased risk for atherosclerotic vascular disease.
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Kane et al. (2021) studied this question.
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