Review article
Epigenetics and diabetic cardiomyopathy

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Abstract

Cardiovascular complications are a chief cause of mortality and morbidity in diabetic patients. Recent studies suggest that epigenetic changes which may arise as a consequence of environmental factors play an important role in predisposition to disease. Epigenetic mechanisms such as DNA methylation, chromatin remodeling and histone modifications regulate the gene expression in response to environmental signals. Role of epigenetics has been recognized in the pathology of diabetes, however its role in diabetic associated cardiomyopathy remains largely unexplored. In this article, we review current literature on the epigenetic mechanisms involved in diabetes and discuss recent evidence of epigenetic changes that may play an important role in pathophysiology of DCM.

Section snippets

Diabetic cardiomyopathy

Diabetes is the most common modifiable risk factor, and is a significant contributor to death and disability worldwide [1], [2]. Diabetes is a complex, heritable disease of multi-factorial etiology that involves the interactions between environmental factors and multiple genetic susceptibility alleles. It is the most common cause of cardiovascular disease and associated morbidity and mortality [3]. It has been found that around 80% of diabetes associated deaths are due to cardiovascular

Epigenetics

Epigenetics has been described as the heritable changes in gene function that occur without a change in the nucleotide sequence [10]. Epigenetics refers to DNA and chromatin modifications that persist from one cell division to the next (mitotic inheritance) despite a lack of change in the underlying DNA sequence. Some epigenetic changes can also follow trans-generational inheritance (meiotic inheritance) meaning that these changes can be passed on from one generation to the next [11]. Both

Diabetes and epigenetics

Recent epidemiological and clinical studies have shown that some patients of type 2 diabetes develop diabetic vascular complications even with intensive glycemic control. It has been suggested that this could be due to a metabolic memory stemming from prior hyperglycemic levels. The mechanisms responsible for these enduring effects of the prior hyperglycemic state or erratic metabolic control are still not well understood. Preliminary studies suggest that transient hyperglycemia can influence

Potential role of epigenetics in diabetic cardiomyopathy

Persistent hyperglycemia is an important factor involved in the etiology of diabetes associated cardiovascular complications. Functional and structural changes in diabetic heart may result from factors such as: metabolic disturbances, altered fuel metabolism abnormalities in ion homeostasis, inflammation, oxidative stress, etc. [42]. However, the molecular mechanisms that govern these chronic changes remain poorly defined. Expression of several genes participating in these pathways such as

Conclusion

The epigenetic mechanisms are being increasingly implicated in pathophysiology of complex diseases such as diabetes where environmental factors play an important role. Recent studies have shown that long lasting epigenetic modifications such as histone modifications and DNA methylation play an important role in regulation of many genes involved in diabetes and diabetes nephropathy. However, the contribution of epigenetic factors in diabetes cardiomyopathy – a long lasting complication of

Conflict of interest

The authors declare that they have no conflict of interest.

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