Biomarkers of Endothelial Dysfunction and Risk of Type 2 Diabetes Mellitus

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Abstract
Type 2 diabetes mellitus is increasingly prevalent worldwide,1 conferring major burdens on health and health care costs. Type 2 diabetes may be largely preventable,2,3 but a comprehensive understanding of its etiology is still needed. Development of atherosclerotic cardiovascular disease (CVD) is the principal complication in type 2 diabetes, but clinical CVD can also precede development of diabetes,4 lending support to the hypothesis that diabetes and CVD share common antecedents. A syndrome of insulin resistance may constitute this common antecedent,5 but mechanisms unifying diverse effects of insulin resistance are not well defined. Insulin resistance is an established factor in the pathogenesis of type 2 diabetes but has an uncertain association with CVD.6