Figure 2.

Pathogenesis of atherosclerosis. Atherosclerosis may be caused by environmental and genetic factors. The onset of atherosclerosis is during ED initial occurrence, which is also associated with the onset of IR. These incidences reflect pre-diabetes and pre-CVD phases, and symptoms of complications may appear. Ongoing atherosclerosis development is incessantly supported by ED, linked to the release and regulation of inflammatory cytokines and chemokines, as well as IR, which develops into hyperinsulinemia. At this stage, patients may have developed advanced atherosclerosis and diabetes, while exhibiting evident complications. Further ED, IR, and atherosclerosis advancement will result in more apparent complications and CAD development. Abbreviations: CAD, coronary artery disease; CVD, cardiovascular disease; ED, endothelial dysfunction; IR, insulin resistance.