Epigenetic Changes, Oxidative Stress and CV Damage in Diabetes

Type 2 diabetes mellitus (T2DM) is associated with increased risk of micro- and macrovascular complications and approximate two-fold greater risk of mortality as compared with the general population. Advances in therapy have reduced morbidity and mortality in patients with T2DM. However, cardiovascular risk is far to be eradicated and mechanism-based therapeutic approaches are needed. In patients with obesity and diabetes endothelial inflammation, mitochondrial oxidative stress and reduced availability of nitric oxide, a key effector of vascular health are common features. This chain of events favors the development of cardiovascular damage. Although the link between elevated cardiometabolic risk and atherosclerosis is well established, a better comprehension of the underlying mechanisms is of utmost importance to identify novel molecular targets. Adverse chromatin remodeling is emerging as a key driver of vascular damage and may play a role in this setting