End-Organ Damage Mechanisms · USMLE Step 1

How does chronic hyperglycemia in diabetes accelerate atherosclerosis and macrovascular end-organ damage?

  1. By lowering circulating LDL cholesterol concentration
  2. By causing autoimmune destruction of vascular smooth muscle
  3. By driving oxidative stress, endothelial injury and foam cell formation
  4. By markedly increasing parasympathetic nervous tone
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Correct answer: By driving oxidative stress, endothelial injury and foam cell formation

Hyperglycemia induces oxidative stress and inflammation, damages endothelium, enhances LDL oxidation and uptake by macrophages — promoting foam cell formation, plaque development, and macrovascular disease.

Difficulty: Medium Question 12 of 20

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