{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T16:45:05Z","timestamp":1791996305363,"version":"4.4.0"},"reference-count":106,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2024,1,9]],"date-time":"2024-01-09T00:00:00Z","timestamp":1704758400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000062","name":"National Institute of Diabetes and Digestive and Kidney Diseases","doi-asserted-by":"publisher","award":["DK124329"],"award-info":[{"award-number":["DK124329"]}],"id":[{"id":"10.13039\/100000062","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000062","name":"National Institute of Diabetes and Digestive and Kidney Diseases","doi-asserted-by":"publisher","award":["RO1HL085119"],"award-info":[{"award-number":["RO1HL085119"]}],"id":[{"id":"10.13039\/100000062","id-type":"DOI","asserted-by":"publisher"}]},{"name":"National Heart, Lung, and Blood Institute","award":["DK124329"],"award-info":[{"award-number":["DK124329"]}]},{"name":"National Heart, Lung, and Blood Institute","award":["RO1HL085119"],"award-info":[{"award-number":["RO1HL085119"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJMS"],"abstract":"<jats:p>Clinical and basic studies have documented that both hyperglycemia and insulin-resistance\/hyperinsulinemia not only constitute metabolic disorders contributing to cardiometabolic syndrome, but also predispose to diabetic vasculopathy, which refers to diabetes-mellitus-induced microvascular and macrovascular complications, including retinopathy, neuropathy, atherosclerosis, coronary artery disease, hypertension, and peripheral artery disease. The underlying molecular and cellular mechanisms include inappropriate activation of the renin angiotensin\u2013aldosterone system, mitochondrial dysfunction, excessive oxidative stress, inflammation, dyslipidemia, and thrombosis. These abnormalities collectively promote metabolic disorders and further promote diabetic vasculopathy. Recent evidence has revealed that endothelial progenitor cell dysfunction, gut dysbiosis, and the abnormal release of extracellular vesicles and their carried microRNAs also contribute to the development and progression of diabetic vasculopathy. Therefore, clinical control and treatment of diabetes mellitus, as well as the development of novel therapeutic strategies are crucial in preventing cardiometabolic syndrome and related diabetic vasculopathy. The present review focuses on the relationship between insulin resistance and diabetes mellitus in diabetic vasculopathy and related cardiovascular disease, highlighting epidemiology and clinical characteristics, pathophysiology, and molecular mechanisms, as well as management strategies.<\/jats:p>","DOI":"10.3390\/ijms25020804","type":"journal-article","created":{"date-parts":[[2024,1,9]],"date-time":"2024-01-09T04:38:51Z","timestamp":1704775131000},"page":"804","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":114,"title":["Diabetic Vasculopathy: Molecular Mechanisms and Clinical Insights"],"prefix":"10.3390","volume":"25","author":[{"given":"George","family":"Jia","sequence":"first","affiliation":[{"name":"Department of Medicine\u2014Endocrinology and Metabolism, University of Missouri School of Medicine, Columbia, MO 65212, USA"},{"name":"Department of Biology, Washington University in St Louis, St. Louis, MO 63130, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hetty","family":"Bai","sequence":"additional","affiliation":[{"name":"Department of Medicine\u2014Endocrinology and Metabolism, University of Missouri School of Medicine, Columbia, MO 65212, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bethany","family":"Mather","sequence":"additional","affiliation":[{"name":"Department of Medicine\u2014Endocrinology and Metabolism, University of Missouri School of Medicine, Columbia, MO 65212, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael A.","family":"Hill","sequence":"additional","affiliation":[{"name":"Department of Medical Pharmacology and Physiology, University of Missouri School of Medicine, Columbia, MO 65212, USA"},{"name":"Dalton Cardiovascular Research Center, University of Missouri, Columbia, MO 65212, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0018-5925","authenticated-orcid":false,"given":"Guanghong","family":"Jia","sequence":"additional","affiliation":[{"name":"Department of Medicine\u2014Endocrinology and Metabolism, University of Missouri School of Medicine, Columbia, MO 65212, USA"},{"name":"Dalton Cardiovascular Research Center, University of Missouri, Columbia, MO 65212, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James R.","family":"Sowers","sequence":"additional","affiliation":[{"name":"Department of Medicine\u2014Endocrinology and Metabolism, University of Missouri School of Medicine, Columbia, MO 65212, USA"},{"name":"Department of Medical Pharmacology and Physiology, University of Missouri School of Medicine, Columbia, MO 65212, USA"},{"name":"Dalton Cardiovascular Research Center, University of Missouri, Columbia, MO 65212, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,1,9]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"624","DOI":"10.1161\/CIRCRESAHA.117.311586","article-title":"Diabetic Cardiomyopathy: An Update of Mechanisms Contributing to This Clinical Entity","volume":"122","author":"Jia","year":"2018","journal-title":"Circ. 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