Abstract
PURPOSE: This study explored the therapeutic potential of puerarin in diabetic atherosclerosis (DA) by targeting endothelial dysfunction and lipid metabolism in apolipoprotein E (APOE)-/- mice. METHODS: In vitro, human aortic endothelial immortalized cells cultured under high glucose conditions were treated with puerarin. Cell viability was quantified using cell counting kit-8 (CCK-8) assay. Apoptosis rates were measured via Annexin V/PI flow cytometry. Lipid accumulation was assessed through Oil Red O staining. iNOS levels were detected by ELISA. In vivo, diabetic APOE-/- mice fed a high-fat diet received daily puerarin administration. Aortic collagen deposition was evaluated using Masson trichrome staining. Plaque burden was analyzed via hematoxylin-eosin staining. Serum lipid profiles, including low-density lipoprotein cholesterol and high-density lipoprotein cholesterol, were determined by enzymatic assays. Follistatin-like 1 (Fstl1) protein expression and downstream inflammatory mediators were examined through Western blot and immunofluorescence. RESULTS: Puerarin significantly improved endothelial cell survival and reduced apoptosis under high glucose. Lipid droplet formation decreased alongside iNOS suppression. In diabetic mice, puerarin attenuated aortic plaque area and collagen content while improving dyslipidemia. Fstl1 expression and associated inflammatory markers were downregulated. CONCLUSION: Puerarin alleviates DA progression through dual modulation of endothelial protection and Fstl1-mediated inflammatory pathways.