Type 2 diabetes mellitus and cardiovascular risk; what the pharmacotherapy can change through the epigenetics

Postgrad Med. 2020 Mar;132(2):109-125. doi: 10.1080/00325481.2019.1681215. Epub 2019 Oct 29.

Abstract

Diabetes mellitus and cardiovascular diseases are part of the metabolic syndrome and share similar risk factors, including obesity, arterial hypertension, and dyslipidemia. Atherosclerosis and insulin resistance contribute to the development of the diseases, and subclinical inflammation is observed in both conditions. There are many proofs about the connection between epigenetic factors and different diseases, including diabetes and cardiovascular diseases. Interestingly, recent studies show that at least some anti-diabetic drugs, as well as blockers of the renin-angiotensin-aldosterone system (RAAS), exert epigenetic effects aside from their hypoglycemic and antihypertensive functions, respectively. More studies are needed to discover other positive effects of the medications established through epigenetic mechanisms and to find out more about the epigenetic role in the development of diabetes mellitus and cardiovascular diseases.

Keywords: Diabetes mellitus; epigenetics; pharmacotherapy; renin-angiotensin system.

Publication types

  • Review

MeSH terms

  • Alarmins / metabolism
  • Antihypertensive Agents / pharmacology
  • Antihypertensive Agents / therapeutic use
  • Cardiovascular Diseases / drug therapy*
  • Cardiovascular Diseases / epidemiology
  • Cardiovascular Diseases / genetics*
  • Chromatin / metabolism
  • DNA Methylation / physiology
  • Diabetes Mellitus, Type 2 / drug therapy*
  • Diabetes Mellitus, Type 2 / epidemiology
  • Diabetes Mellitus, Type 2 / genetics*
  • Endothelium, Vascular / metabolism
  • Epigenesis, Genetic*
  • Extracellular Traps / metabolism
  • Gastrointestinal Microbiome / genetics
  • Histones / metabolism
  • Homocysteine / metabolism
  • Humans
  • Hyperhomocysteinemia / epidemiology
  • Hyperhomocysteinemia / metabolism
  • Hypertension / drug therapy
  • Hypoglycemic Agents / pharmacology
  • Hypoglycemic Agents / therapeutic use
  • Insulin / genetics
  • Metabolic Syndrome / epidemiology
  • Metabolic Syndrome / genetics
  • RNA, Untranslated
  • Renin-Angiotensin System / drug effects
  • Renin-Angiotensin System / physiology
  • Risk Factors

Substances

  • Alarmins
  • Antihypertensive Agents
  • Chromatin
  • Histones
  • Hypoglycemic Agents
  • Insulin
  • RNA, Untranslated
  • Homocysteine