Mechanisms for forming endothelium dysfunction in insulin-resistant conditions

Abstract

In pathogenesis and clinic of arterial hypertension, atherosclerosis, diabetes mellitus and their complications, one of the important aspects is the violation of the structure and function of the endothelium. In these diseases, it appears as the primary organ of the target, as the endothelial lining of the vessels participates in the regulation of vascular tone, hemostasis, immune response, migration of blood cells to the vascular wall, the synthesis of inflammatory factors and their inhibitors, and performs barrier functions. Endothelial dysfunction (ED) is characterized by a shift in the endothelium towards decreasing vasodilation, proinflammatory state and prothrombotic properties. Currently, ED is considered as a universal mechanism for the formation and progression of any vascular pathology, especially in patients with type 2 diabetes. In routine clinical practice, the detection of ED is not carried out, but it must be understood that endothelial dysfunction is one of the first manifestations of vascular pathology, which appears long before the clinical manifestation of cardiovascular diseases. The review provides data on the functions and dysfunctions of the vascular endothelium, and also presents the modern concept of ED as the central link in many chronic diseases.