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World J Transl Med. Sep 28, 2026; 12(3): 123615
Published online Sep 28, 2026. doi: 10.5528/wjtm.123615
Published online Sep 28, 2026. doi: 10.5528/wjtm.123615
Arterial stiffness and endothelial dysfunction in diabetes mellitus
Tomoyuki Kabutoya, Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Shimotsuke 3290498, Tochigi, Japan
Author contributions: Kabutoya T conceived the idea for the review, conducted the literature search, analyzed the relevant publications, wrote the manuscript, and reviewed and approved the final version of the manuscript.
AI contribution statement: AI tools (ChatGPT) were used solely to assist in the initial conceptual development and organization of the framework presented in Figure 1. No AI tool was used for study design, literature selection, interpretation of evidence, formulation of conclusions, or reference preparation. The final figure was independently created, edited, and validated by the authors using Microsoft PowerPoint. During the preparation of the revised manuscript and the response to reviewers, ChatGPT (Copilot) was used solely to assist with improving language, readability, and grammar.
Conflict-of-interest statement: The author reports no relevant conflicts of interest for this article.
Corresponding author: Tomoyuki Kabutoya, Associate Professor, Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, 3311-1 Yakushiji, Shimotsuke 3290498, Tochigi, Japan. kabu@jichi.ac.jp
Received: May 26, 2026
Revised: July 18, 2026
Accepted: July 28, 2026
Published online: September 28, 2026
Processing time: 102 Days and 20.5 Hours
Revised: July 18, 2026
Accepted: July 28, 2026
Published online: September 28, 2026
Processing time: 102 Days and 20.5 Hours
Core Tip
Core Tip: Diabetes mellitus accelerates vascular aging through the concurrent progression of arterial stiffness and endothelial dysfunction, both of which independently contribute to cardiovascular risk. Noninvasive vascular indices - including pulse wave velocity, the cardio-ankle vascular index, flow-mediated dilation, and reactive hyperemia-peripheral arterial tonometry - capture distinct but complementary aspects of diabetic vascular pathology. These measures are not interchangeable; rather, their integrated assessment may enhance early detection of subclinical vascular damage and improve cardiovascular risk stratification beyond traditional risk factors in patients with diabetes.