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The Role of Haptoglobin Polymorphism in Cardiovascular Disease in the Setting of Diabetes

Atherosclerotic cardiovascular disease (CVD) is the major cause of morbidity and mortality in individuals with diabetes mellitus (DM). Preclinical models have suggested that excessive oxidative stress and hyperglycemia are directly responsible for this pathological association. However, numerous cli...

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Autores principales: Somer, Shmuel, Levy, Andrew P.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7796233/
https://www.ncbi.nlm.nih.gov/pubmed/33396615
http://dx.doi.org/10.3390/ijms22010287
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author Somer, Shmuel
Levy, Andrew P.
author_facet Somer, Shmuel
Levy, Andrew P.
author_sort Somer, Shmuel
collection PubMed
description Atherosclerotic cardiovascular disease (CVD) is the major cause of morbidity and mortality in individuals with diabetes mellitus (DM). Preclinical models have suggested that excessive oxidative stress and hyperglycemia are directly responsible for this pathological association. However, numerous clinical trials involving the administration of high doses of the antioxidant vitamin E or attempts at strict glycemic control have failed to show a significant reduction of CVD in DM patients. We describe here a possible explanation for the failure of these trials, that being their lack of proper patient selection. The haptoglobin (Hp) genotype is a major determinant of the risk of CVD in the setting of DM. Treatment of individuals with the high-risk Hp genotype with antioxidants or aggressive glycemic control has shown benefit in several small studies. These studies suggest a precision medicine-based approach to preventing diabetes complications. This approach would have a profound effect on the costs of diabetes care and could dramatically reduce morbidity from diabetes.
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spelling pubmed-77962332021-01-10 The Role of Haptoglobin Polymorphism in Cardiovascular Disease in the Setting of Diabetes Somer, Shmuel Levy, Andrew P. Int J Mol Sci Review Atherosclerotic cardiovascular disease (CVD) is the major cause of morbidity and mortality in individuals with diabetes mellitus (DM). Preclinical models have suggested that excessive oxidative stress and hyperglycemia are directly responsible for this pathological association. However, numerous clinical trials involving the administration of high doses of the antioxidant vitamin E or attempts at strict glycemic control have failed to show a significant reduction of CVD in DM patients. We describe here a possible explanation for the failure of these trials, that being their lack of proper patient selection. The haptoglobin (Hp) genotype is a major determinant of the risk of CVD in the setting of DM. Treatment of individuals with the high-risk Hp genotype with antioxidants or aggressive glycemic control has shown benefit in several small studies. These studies suggest a precision medicine-based approach to preventing diabetes complications. This approach would have a profound effect on the costs of diabetes care and could dramatically reduce morbidity from diabetes. MDPI 2020-12-30 /pmc/articles/PMC7796233/ /pubmed/33396615 http://dx.doi.org/10.3390/ijms22010287 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Review
Somer, Shmuel
Levy, Andrew P.
The Role of Haptoglobin Polymorphism in Cardiovascular Disease in the Setting of Diabetes
title The Role of Haptoglobin Polymorphism in Cardiovascular Disease in the Setting of Diabetes
title_full The Role of Haptoglobin Polymorphism in Cardiovascular Disease in the Setting of Diabetes
title_fullStr The Role of Haptoglobin Polymorphism in Cardiovascular Disease in the Setting of Diabetes
title_full_unstemmed The Role of Haptoglobin Polymorphism in Cardiovascular Disease in the Setting of Diabetes
title_short The Role of Haptoglobin Polymorphism in Cardiovascular Disease in the Setting of Diabetes
title_sort role of haptoglobin polymorphism in cardiovascular disease in the setting of diabetes
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7796233/
https://www.ncbi.nlm.nih.gov/pubmed/33396615
http://dx.doi.org/10.3390/ijms22010287
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