Insulin resistance, oxidative stress and cardiovascular complications: role of sirtuins.

Cardiovascular disease (CVD) is one of the major lifestyle associated disorders and leading causes of death worldwide. The incidence of CVD in diabetic patients has increased up to 3 folds and it became the major risk for diabetes associated morbidity and mortality. Insulin resistance and oxidative stress both play a central role in the pathogenesis and progression of diabetes. The high prevalence of CVD among diabetic patients suggests the role of insulin resistance and oxidative stress in developing cardiovascular complications. Finding molecular mechanisms which could control both insulin resistance and oxidative stress would be more efficacious in improving the cardiovascular complications. Recent literatures show that an epigenetic mechanism could control or regulate the cardiovascular complications in diabetes. Sirtuins, a group of enzymes, modulate epigenetic changes by deacetylating histone and non-histone proteins. These enzymes are distributed in different cell organelles and are found to regulate different biological processes. Recent findings showed that sirtuins modulate different important proteins related to insulin signaling pathway and oxidative stress. This review summarizes how sirtuins could affect the insulin resistance and oxidative stress pathways in cardiovascular system and thus attenuate the cardiovascular complications. Understanding the role of sirtuins in insulin resistance and oxidative stress will increase the prospects for controlling or preventing cardiovascular complications in the future.