The Relationship of Diet and Atherosclerosis in Diabetic Macaca Nigra

Abstract

Any possibility of gaining a clear view of the relationship between dietary carbohydrate and atherosclerosis depends upon clarification of the numerous metabolic events that interrelate carbohydrate management, insulin, and blood lipids; aberrations are reflected in obesity, coronary heart disease, and atherosclerosis. The ability to deal effectively with these various metabolic factors is hampered by not knowing which events are primary and which are secondary. Central to maintaining balanced glucose and lipid metabolism appears to be the capacity to produce, secrete, and utilize insulin. The defects in insulin control that accompany diabetes mellitus are apparent in hyperglycemia, glucose intolerance, and increased blood lipids. The last arises both because of the increased amount of carbohydrate available for lipid synthesis and because of the deranged lipid metabolism that stems from insulin abnormalities. The development of atherosclerotic lesions depends upon both in situ metabolism and external constituents in the blood. The role of insulin in this development may represent an anomaly in lesion development: on the one hand, excessive insulin can increase lipogenesis and other anabolic processes within the aorta; on the other, insulin deficiency could lead to changes in aortic metabolism as well as to increased blood glucose and lipids which further encourage the development of aortic lesions.