REFERENCES
1. Duncan BB, Magliano DJ, Boyko EJ. IDF diabetes atlas 11th edition 2025: global prevalence and projections for 2050. Nephrol Dial Transplant. 2025;41:7-9.
2. Seferović PM, Paulus WJ, Rosano G, et al. Diabetic myocardial disorder. A clinical consensus statement of the Heart Failure Association of the ESC and the ESC Working Group on Myocardial & Pericardial Diseases. Eur J Heart Fail. 2024;26:1893-903.
3. Segar MW, Khan MS, Patel KV, et al. Prevalence and prognostic implications of diabetes with cardiomyopathy in community-dwelling adults. J Am Coll Cardiol. 2021;78:1587-98.
4. Galeone A, Annicchiarico A, Buccoliero C, et al. Diabetic cardiomyopathy: role of cell death, exosomes, fibrosis and epicardial adipose tissue. Int J Mol Sci. 2024;25:9481.
5. Sanganalmath SK, Dubey S, Veeranki S, Narisetty K, Krishnamurthy P. The interplay of inflammation, exosomes and Ca2+ dynamics in diabetic cardiomyopathy. Cardiovasc Diabetol. 2023;22:37.
6. Liu S, Pan Z, Chen X, et al. The emerging role of extracellular vesicles in diabetes and complications: mechanistic insights and translational prospects. Front Endocrinol. 2025;16:1674028.
7. Welsh JA, Goberdhan DCI, O’Driscoll L, et al. ; MISEV Consortium. Minimal information for studies of extracellular vesicles (MISEV2023): from basic to advanced approaches. J Extracell Vesicles. 2024;13:e12404.
8. Yu Y, Yang X, Yin Y, Qin L, Xiang Q, Yu R. Exosomal microRNA in diabetic myocardial disorder: mechanisms, diagnosis, and treatment. Biomed Pharmacother. 2025;193:118761.
9. Wang M, Chen Y, Xu B, et al. Recent advances in the roles of extracellular vesicles in cardiovascular diseases: pathophysiological mechanisms, biomarkers, and cell-free therapeutic strategy. Mol Med. 2025;31:169.
10. Arya SB, Collie SP, Parent CA. The ins-and-outs of exosome biogenesis, secretion, and internalization. Trends Cell Biol. 2024;34:90-108.
11. Carvalho Ferraz L, Pereira P, Ferreira JV. Molecular mechanisms of extracellular vesicle biogenesis and their impact on the design of custom EVs. Adv Healthc Mater. 2025;14:e2501349.
12. Lu T, Zheng Y, Chen X, Lin Z, Liu C, Yuan C. The role of exosome derived miRNAs in inter-cell crosstalk among insulin-related organs in type 2 diabetes mellitus. J Physiol Biochem. 2024;80:501-10.
13. Abbas A, Almaghrbi H, Giordo R, Zayed H, Pintus G. Pathogenic mechanisms, diagnostic, and therapeutic potential of microvesicles in diabetes and its complications. Arch Biochem Biophys. 2024;761:110168.
14. Renu K. A molecular perspective on the intricate interplay among exosomes, bioenergetic metabolism, and the pathogenesis of diabetic cardiomyopathy. J Cardiovasc Transl Res. 2025;18:1707-22.
15. Zhang W, Song M, Fang Z, et al. Role of extracellular vesicles in insulin resistance: Signaling pathways, bioactive substances, miRNAs, and therapeutic potential. Cell Biochem Funct. 2024;42:e4013.
16. Rohm TV, Cunha E Rocha K, Olefsky JM. Metabolic messengers: small extracellular vesicles. Nat Metab. 2025;7:253-62.
17. Malin SK, Erdbrügger U. Extracellular vesicles in metabolic and vascular insulin resistance. J Vasc Res. 2024;61:129-41.
18. Paneru BD, Hill DA. The role of extracellular vesicle-derived miRNAs in adipose tissue function and metabolic health. Immunometabolism. 2023;5:e00027.
19. Marchand A, Atassi F, Mougenot N, et al. miR-322 regulates insulin signaling pathway and protects against metabolic syndrome-induced cardiac dysfunction in mice. Biochim Biophys Acta. 2016;1862:611-21.
20. Lark DS, Stemmer K, Ying W, Crewe C. A brief guide to studying extracellular vesicle function in the context of metabolism. Nat Metab. 2024;6:1839-41.
21. Liu L, An Z, Zhang H, et al. Bone marrow mesenchymal stem cell-derived extracellular vesicles alleviate diabetes-exacerbated atherosclerosis via AMPK/mTOR pathway-mediated autophagy-related macrophage polarization. Cardiovasc Diabetol. 2025;24:48.
22. Zhang T, Gao Z, Chen K. Exosomal microRNAs: potential targets for the prevention and treatment of diabetic cardiomyopathy. J Cardiol. 2022;80:423-31.
23. Horie T, Ono K, Nishi H, et al. MicroRNA-133 regulates the expression of GLUT4 by targeting KLF15 and is involved in metabolic control in cardiac myocytes. Biochem Biophys Res Commun. 2009;389:315-20.
24. Blumensatt M, Greulich S, Herzfeld de Wiza D, et al. Activin A impairs insulin action in cardiomyocytes via up-regulation of miR-143. Cardiovasc Res. 2013;100:201-10.
25. Lu H, Buchan RJ, Cook SA. MicroRNA-223 regulates Glut4 expression and cardiomyocyte glucose metabolism. Cardiovasc Res. 2010;86:410-20.
26. Hu J, Wang S, Xiong Z, et al. Exosomal Mst1 transfer from cardiac microvascular endothelial cells to cardiomyocytes deteriorates diabetic cardiomyopathy. Biochim Biophys Acta Mol Basis Dis. 2018;1864:3639-49.
27. Zhu Y, Pereira RO, O’Neill BT, et al. Cardiac PI3K-Akt impairs insulin-stimulated glucose uptake independent of mTORC1 and GLUT4 translocation. Mol Endocrinol. 2013;27:172-84.
28. Xing Z, Schocken DD, Zgibor JC, Alman AC. Course and trajectories of insulin resistance, incident heart failure and all-cause mortality in nondiabetic people. Endocrine. 2025;87:530-42.
29. Witteles RM, Tang WH, Jamali AH, Chu JW, Reaven GM, Fowler MB. Insulin resistance in idiopathic dilated cardiomyopathy: a possible etiologic link. J Am Coll Cardiol. 2004;44:78-81.
30. Sun Y, Shi H, Yin S, et al. Human mesenchymal stem cell derived exosomes alleviate type 2 diabetes mellitus by reversing peripheral insulin resistance and relieving β-cell destruction. ACS Nano. 2018;12:7613-28.
31. Gan L, Zhao J, Yao P, et al. Adipocyte-derived small extracellular vesicles exacerbate diabetic ischemic heart injury by promoting oxidative stress and mitochondrial-mediated cardiomyocyte apoptosis. Redox Biol. 2025;79:103443.
32. Wang X, Huang W, Liu G, et al. Cardiomyocytes mediate anti-angiogenesis in type 2 diabetic rats through the exosomal transfer of miR-320 into endothelial cells. J Mol Cell Cardiol. 2014;74:139-50.
33. Zhu Y, Yang X, Zhou J, et al. miR-340-5p mediates cardiomyocyte oxidative stress in diabetes-induced cardiac dysfunction by targeting Mcl-1. Oxid Med Cell Longev. 2022;2022:3182931.
34. Das S, Kohr M, Dunkerly-Eyring B, et al. Divergent effects of mir-181 family members on myocardial function through protective cytosolic and detrimental mitochondrial microRNA targets. J Am Heart Assoc. 2017;6:e004694.
35. el Azzouzi H, Leptidis S, Dirkx E, et al. The hypoxia-inducible microRNA cluster miR-199a∼214 targets myocardial PPARδ and impairs mitochondrial fatty acid oxidation. Cell Metab. 2013;18:341-54.
36. Tang Q, Len Q, Liu Z, Wang W. Overexpression of miR-22 attenuates oxidative stress injury in diabetic cardiomyopathy via Sirt 1. Cardiovasc Ther. 2018;36:1-11.
37. Yu M, Sun Y, Shan X, et al. Therapeutic overexpression of miR-92a-2-5p ameliorated cardiomyocyte oxidative stress injury in the development of diabetic cardiomyopathy. Cell Mol Biol Lett. 2022;27:85.
38. Yu M, Liu Y, Zhang B, Shi Y, Cui L, Zhao X. Inhibiting microRNA-144 abates oxidative stress and reduces apoptosis in hearts of streptozotocin-induced diabetic mice. Cardiovasc Pathol. 2015;24:375-81.
39. Su M, Wang J, Wang C, et al. MicroRNA-221 inhibits autophagy and promotes heart failure by modulating the p27/CDK2/mTOR axis. Cell Death Differ. 2015;22:986-99.
40. Miao Y, Wan Q, Liu X, et al. miR-503 is involved in the protective effect of phase II enzyme inducer (CPDT) in diabetic cardiomyopathy via Nrf2/ARE signaling pathway. Biomed Res Int. 2017;2017:9167450.
41. Baseler WA, Thapa D, Jagannathan R, Dabkowski ER, Croston TL, Hollander JM. miR-141 as a regulator of the mitochondrial phosphate carrier (Slc25a3) in the type 1 diabetic heart. Am J Physiol Cell Physiol. 2012;303:C1244-51.
42. Wang S, Duan J, Liao J, et al. LncRNA H19 inhibits ER stress induced apoptosis and improves diabetic cardiomyopathy by regulating PI3K/AKT/mTOR axis. Aging. 2022;14:6809-28.
43. Yin Z, Zhao Y, He M, et al. MiR-30c/PGC-1β protects against diabetic cardiomyopathy via PPARα. Cardiovasc Diabetol. 2019;18:7.
44. Duan Q, Chen C, Yang L, et al. MicroRNA regulation of unfolded protein response transcription factor XBP1 in the progression of cardiac hypertrophy and heart failure in vivo. J Transl Med. 2015;13:363.
45. Bai Y, Zhang Y, Han B, et al. Circular RNA DLGAP4 ameliorates ischemic stroke outcomes by targeting miR-143 to regulate endothelial-mesenchymal transition associated with blood-brain barrier integrity. J Neurosci. 2018;38:32-50.
46. Ren L, Wang Q, Chen Y, Ma Y, Wang D. Involvement of microRNA-133a in the protective effect of hydrogen sulfide against ischemia/reperfusion-induced endoplasmic reticulum stress and cardiomyocyte apoptosis. Pharmacology. 2019;103:1-9.
47. Li J, Xie Y, Zheng S, et al. Targeting autophagy in diabetic cardiomyopathy: From molecular mechanisms to pharmacotherapy. Biomed Pharmacother. 2024;175:116790.
48. Yan M, Zhang S, Liang P, et al. Research hotspots and frontier trends of autophagy in diabetic cardiomyopathy from 2014 to 2024: a bibliometric analysis. J Multidiscip Healthc. 2025;18:837-60.
49. Zhuo C, Jiang R, Lin X, Shao M. LncRNA H19 inhibits autophagy by epigenetically silencing of DIRAS3 in diabetic cardiomyopathy. Oncotarget. 2017;8:1429-37.
50. Feng Y, Xu W, Zhang W, Wang W, Liu T, Zhou X. LncRNA DCRF regulates cardiomyocyte autophagy by targeting miR-551b-5p in diabetic cardiomyopathy. Theranostics. 2019;9:4558-66.
51. Chen D, Zhang M. GAS5 regulates diabetic cardiomyopathy via miR-221-3p/p27 axis-associated autophagy. Mol Med Rep. 2021;23:135.
52. Qian LB, Jiang SZ, Tang XQ, et al. Exacerbation of diabetic cardiac hypertrophy in OVE26 mice by angiotensin II is associated with JNK/c-Jun/miR-221-mediated autophagy inhibition. Oncotarget. 2017;8:106661-71.
53. Xiao C, Chen MY, Han YP, Liu LJ, Yan JL, Qian LB. The protection of luteolin against diabetic cardiomyopathy in rats is related to reversing JNK-suppressed autophagy. Food Funct. 2023;14:2740-9.
54. Shyu KG, Wang BW, Pan CM, Fang WJ. Macrophage-derived exosomal MALAT1 regulates autophagy through miR-204-5p/ATG7 axis in H9C2 cardiomyocytes and diabetic rat heart. Acta Cardiol Sin. 2025;41:346-60.
55. XiaoTian L, QiNan W, XiaGuang G, WuQuan D, Bing C, ZiWen L. Exenatide activates the APPL1-AMPK-PPARα axis to prevent diabetic cardiomyocyte apoptosis. J Diabetes Res. 2016;2016:4219735.
56. Xiao J, Pan Y, Li XH, et al. Cardiac progenitor cell-derived exosomes prevent cardiomyocytes apoptosis through exosomal miR-21 by targeting PDCD4. Cell Death Dis. 2016;7:e2277.
57. Mayourian J, Ceholski DK, Gorski PA, et al. Exosomal microRNA-21-5p mediates mesenchymal stem cell paracrine effects on human cardiac tissue contractility. Circ Res. 2018;122:933-44.
58. Liu Y, Zhong C, Chen S, et al. Circulating exosomal mir-16-2-3p is associated with coronary microvascular dysfunction in diabetes through regulating the fatty acid degradation of endothelial cells. Cardiovasc Diabetol. 2024;23:60.
59. Liu H, Zhang Y, Yuan J, et al. Dendritic cell-derived exosomal miR-494-3p promotes angiogenesis following myocardial infarction. Int J Mol Med. 2021;47:315-25.
60. Gao L, Wang X, Guo S, et al. LncRNA HOTAIR functions as a competing endogenous RNA to upregulate SIRT1 by sponging miR-34a in diabetic cardiomyopathy. J Cell Physiol. 2019;234:4944-58.
61. Zheng D, Ma J, Yu Y, et al. Silencing of miR-195 reduces diabetic cardiomyopathy in C57BL/6 mice. Diabetologia. 2015;58:1949-58.
62. Biao K, Dongli S, Tao R, Guohui Z. [Inhibition of microRNA195 attenuates high-glucose induced neonatal cardiomyocytes hypertrophy in vitro]. Zhonghua Xin Xue Guan Bing Za Zhi. 2015;43:712-7.
63. Kuwabara Y, Horie T, Baba O, et al. MicroRNA-451 exacerbates lipotoxicity in cardiac myocytes and high-fat diet-induced cardiac hypertrophy in mice through suppression of the LKB1/AMPK pathway. Circ Res. 2015;116:279-88.
64. Zhang H, Liu J, Qu D, et al. Inhibition of miR-200c restores endothelial function in diabetic mice through suppression of COX-2. Diabetes. 2016;65:1196-207.
65. Feng B, Cao Y, Chen S, Chu X, Chu Y, Chakrabarti S. miR-200b mediates endothelial-to-mesenchymal transition in diabetic cardiomyopathy. Diabetes. 2016;65:768-79.
66. Qiao Y, Zhao Y, Liu Y, et al. miR-483-3p regulates hyperglycaemia-induced cardiomyocyte apoptosis in transgenic mice. Biochem Biophys Res Commun. 2016;477:541-7.
67. Wahlquist C, Jeong D, Rojas-Muñoz A, et al. Inhibition of miR-25 improves cardiac contractility in the failing heart. Nature. 2014;508:531-5.
68. Sabzevari Rad R, Shirvani H, Mahmoodzadeh Hosseini H, Shamsoddini A, Samadi M. Micro RNA-126 promoting angiogenesis in diabetic heart by VEGF/Spred-1/Raf-1 pathway: effects of high-intensity interval training. J Diabetes Metab Disord. 2020;19:1089-96.
69. Feng B, Liu J, Wang E, Su Z, Chakrabarti S. Endothelial derived miRNA-9 mediated cardiac fibrosis in diabetes and its regulation by ZFAS1. PLoS One. 2022;17:e0276076.
70. Duan Y, Zhou B, Su H, Liu Y, Du C. miR-150 regulates high glucose-induced cardiomyocyte hypertrophy by targeting the transcriptional co-activator p300. Exp Cell Res. 2013;319:173-84.
71. Zhao L, Li W, Zhao H. Inhibition of long non-coding RNA TUG1 protects against diabetic cardiomyopathy induced diastolic dysfunction by regulating miR-499-5p. Am J Transl Res. 2020;12:718-30.
72. Wang C, Liu G, Yang H, et al. MALAT1-mediated recruitment of the histone methyltransferase EZH2 to the microRNA-22 promoter leads to cardiomyocyte apoptosis in diabetic cardiomyopathy. Sci Total Environ. 2021;766:142191.
73. Zhou X, Zhang W, Jin M, Chen J, Xu W, Kong X. lncRNA MIAT functions as a competing endogenous RNA to upregulate DAPK2 by sponging miR-22-3p in diabetic cardiomyopathy. Cell Death Dis. 2017;8:e2929.
74. Zhao SF, Ye YX, Xu JD, et al. Long non-coding RNA KCNQ1OT1 increases the expression of PDCD4 by targeting miR-181a-5p, contributing to cardiomyocyte apoptosis in diabetic cardiomyopathy. Acta Diabetol. 2021;58:1251-67.
75. Zou G, Zhong W, Wu F, Wang X, Liu L. Catalpol attenuates cardiomyocyte apoptosis in diabetic cardiomyopathy via Neat1/miR-140-5p/HDAC4 axis. Biochimie. 2019;165:90-9.
76. Li X, Wang H, Yao B, Xu W, Chen J, Zhou X. lncRNA H19/miR-675 axis regulates cardiomyocyte apoptosis by targeting VDAC1 in diabetic cardiomyopathy. Sci Rep. 2016;6:36340.
77. Chen R, Chen H, Yang Z, et al. Danlou tablet inhibits high-glucose-induced cardiomyocyte apoptosis via the miR-34a-SIRT1 axis. Heliyon. 2023;9:e14479.
78. Wang X, Zhang Z, Wang M. MiR-29a regulates cardiomyocyte apoptosis by targeting Bak1 in diabetic cardiomyopathy. J Biochem. 2022;171:663-71.
79. Tao L, Huang X, Xu M, et al. Value of circulating miRNA-21 in the diagnosis of subclinical diabetic cardiomyopathy. Mol Cell Endocrinol. 2020;518:110944.
80. Ghosh N, Fenton S, van Hout I, et al. Therapeutic knockdown of miR-320 improves deteriorated cardiac function in a pre-clinical model of non-ischemic diabetic heart disease. Mol Ther Nucleic Acids. 2022;29:330-42.
81. Pan L, Huang BJ, Ma XE, et al. MiR-25 protects cardiomyocytes against oxidative damage by targeting the mitochondrial calcium uniporter. Int J Mol Sci. 2015;16:5420-33.
82. Żarek-Starzewska A, Klimczak-Tomaniak D, Mądrecka A, Sygitowicz G, Janiszewski M, Kuch M. From type 2 diabetes mellitus to diabetic cardiomyopathy - a systematic review on the role of microRNA. Curr Diab Rep. 2025;25:42.
83. Li X, Du N, Zhang Q, et al. MicroRNA-30d regulates cardiomyocyte pyroptosis by directly targeting foxo3a in diabetic cardiomyopathy. Cell Death Dis. 2014;5:e1479.
84. Knezevic I, Patel A, Sundaresan NR, et al. A novel cardiomyocyte-enriched microRNA, miR-378, targets insulin-like growth factor 1 receptor: implications in postnatal cardiac remodeling and cell survival. J Biol Chem. 2012;287:12913-26.
85. Cheng Y, Zhang D, Zhu M, et al. Liver X receptor α is targeted by microRNA-1 to inhibit cardiomyocyte apoptosis through a ROS-mediated mitochondrial pathway. Biochem Cell Biol. 2018;96:11-8.
86. Kim OH, Noh SW, Choi JS, Jung Y, Oh BC. The SERCA-PLN-DWORF axis in cardiometabolic disease: mechanisms and therapeutic perspectives. Cardiovasc Diabetol. 2025;25:17.
87. Deng S, Tayefi F, Jin Y. Metabolic-stress-induced mitochondrial calcium dysregulation: a central hub in diabetic cardiomyopathy pathogenesis and treatment. Front Endocrinol. 2025;16:1696344.
88. Ma X, Mei S, Wuyun Q, Zhou L, Sun D, Yan J. Epigenetics in diabetic cardiomyopathy. Clin Epigenetics. 2024;16:52.
89. Cha MJ, Jang JK, Ham O, et al. MicroRNA-145 suppresses ROS-induced Ca2+ overload of cardiomyocytes by targeting CaMKIIδ. Biochem Biophys Res Commun. 2013;435:720-6.
90. Fu L, Zhang J, Lin Z, Li Y, Qin G. CircularRNA circ_0071269 knockdown protects against from diabetic cardiomyopathy injury by microRNA-145/gasdermin A axis. Bioengineered. 2022;13:2398-411.
91. Wang C, Zhang C, Liu L, et al. Macrophage-derived mir-155-containing exosomes suppress fibroblast proliferation and promote fibroblast inflammation during cardiac injury. Mol Ther. 2017;25:192-204.
92. Ding M, Shi R, Du Y, et al. O-GlcNAcylation-mediated endothelial metabolic memory contributes to cardiac damage via small extracellular vesicles. Cell Metab. 2025;37:1344-63.e6.
93. Messenger SW, Woo SS, Sun Z, Martin TFJ. A Ca2+-stimulated exosome release pathway in cancer cells is regulated by Munc13-4. J Cell Biol. 2018;217:2877-90.
94. Che H, Wang Y, Li H, et al. Melatonin alleviates cardiac fibrosis via inhibiting lncRNA MALAT1/miR-141-mediated NLRP3 inflammasome and TGF-β1/Smads signaling in diabetic cardiomyopathy. FASEB J. 2020;34:5282-98.
95. Qi Y, Wu H, Mai C, et al. LncRNA-MIAT-mediated miR-214-3p silencing is responsible for IL-17 production and cardiac fibrosis in diabetic cardiomyopathy. Front Cell Dev Biol. 2020;8:243.
96. Liu Y, Zhu Y, Liu S, Liu J, Li X. NORAD lentivirus shRNA mitigates fibrosis and inflammatory responses in diabetic cardiomyopathy via the ceRNA network of NORAD/miR-125a-3p/Fyn. Inflamm Res. 2021;70:1113-27.
97. Dai W, Lee D. Interfering with long chain noncoding RNA ANRIL expression reduces heart failure in rats with diabetes by inhibiting myocardial oxidative stress. J Cell Biochem. 2019;120:18446-56.
98. Huang ZW, Tian LH, Yang B, Guo RM. Long noncoding RNA H19 acts as a competing endogenous RNA to mediate CTGF expression by sponging miR-455 in cardiac fibrosis. DNA Cell Biol. 2017;36:759-66.
99. Yan SM, Li H, Shu Q, Wu WJ, Luo XM, Lu L. LncRNA SNHG1 exerts a protective role in cardiomyocytes hypertrophy via targeting miR-15a-5p/HMGA1 axis. Cell Biol Int. 2020;44:1009-19.
100. Tao H, Zhang JG, Qin RH, et al. LncRNA GAS5 controls cardiac fibroblast activation and fibrosis by targeting miR-21 via PTEN/MMP-2 signaling pathway. Toxicology. 2017;386:11-8.
101. Peng T, Liu M, Hu L, et al. LncRNA Airn alleviates diabetic cardiac fibrosis by inhibiting activation of cardiac fibroblasts via a m6A-IMP2-p53 axis. Biol Direct. 2022;17:32.
102. Lai Y, He S, Ma L, et al. HOTAIR functions as a competing endogenous RNA to regulate PTEN expression by inhibiting miR-19 in cardiac hypertrophy. Mol Cell Biochem. 2017;432:179-87.
103. de Gonzalo-Calvo D, Kenneweg F, Bang C, et al. Circulating long-non coding RNAs as biomarkers of left ventricular diastolic function and remodelling in patients with well-controlled type 2 diabetes. Sci Rep. 2016;6:37354.
104. Chavali V, Tyagi SC, Mishra PK. MicroRNA-133a regulates DNA methylation in diabetic cardiomyocytes. Biochem Biophys Res Commun. 2012;425:668-72.
105. Feng B, Chen S, George B, Feng Q, Chakrabarti S. miR133a regulates cardiomyocyte hypertrophy in diabetes. Diabetes Metab Res Rev. 2010;26:40-9.
106. Hu H, Wang X, Yu H, Wang Z. Extracellular vesicular microRNAs and cardiac hypertrophy. Front Endocrinol. 2024;15:1444940.
107. Shen E, Diao X, Wang X, Chen R, Hu B. MicroRNAs involved in the mitogen-activated protein kinase cascades pathway during glucose-induced cardiomyocyte hypertrophy. Am J Pathol. 2011;179:639-50.
108. Raut SK, Kumar A, Singh GB, et al. miR-30c mediates upregulation of Cdc42 and Pak1 in diabetic cardiomyopathy. Cardiovasc Ther. 2015;33:89-97.
109. Raut SK, Singh GB, Rastogi B, et al. miR-30c and miR-181a synergistically modulate p53-p21 pathway in diabetes induced cardiac hypertrophy. Mol Cell Biochem. 2016;417:191-203.
110. Singh GB, Raut SK, Khanna S, et al. MicroRNA-200c modulates DUSP-1 expression in diabetes-induced cardiac hypertrophy. Mol Cell Biochem. 2017;424:1-11.
111. Huang XH, Li JL, Li XY, et al. miR-208a in cardiac hypertrophy and remodeling. Front Cardiovasc Med. 2021;8:773314.
112. Wang X, Gu H, Huang W, et al. Hsp20-mediated activation of exosome biogenesis in cardiomyocytes improves cardiac function and angiogenesis in diabetic mice. Diabetes. 2016;65:3111-28.
113. Midan HM, Wasfey EF, Doghish AS, Kamal MM, Kassem DH. Harnessing exosomal long non-coding RNAs as a new frontier for molecular diagnostics and therapeutics in diabetes mellitus. Cell Commun Signal. 2026;24:215.
114. Jiao YR, Chen KX, Tang X, et al. Exosomes derived from mesenchymal stem cells in diabetes and diabetic complications. Cell Death Dis. 2024;15:271.
115. Pan W, Li S, Li K, Zhou P. Mesenchymal stem cells and extracellular vesicles: therapeutic potential in organ transplantation. Stem Cells Int. 2024;2024:2043550.
116. Yin X, Wei Y, Liu Y, et al. Reparative effects of VCAM-1 high-performance MSC-derived exosomes on aged diabetic cardiomyocyte injury: a focus on ferroptosis suppression. Apoptosis. 2026;31:9.
117. Gao S, Dong Y, Yan C, Yu T, Cao H. The role of exosomes and exosomal microRNA in diabetic cardiomyopathy. Front Endocrinol. 2023;14:1327495.
118. Rayat Pisheh H, Sani M. Mesenchymal stem cells derived exosomes: a new era in cardiac regeneration. Stem Cell Res Ther. 2025;16:16.
119. Zhang Y, Zhang YY, Li TT, et al. Ablation of interleukin-17 alleviated cardiac interstitial fibrosis and improved cardiac function via inhibiting long non-coding RNA-AK081284 in diabetic mice. J Mol Cell Cardiol. 2018;115:64-72.
120. Zhang Y, Zhu Z, Wang T, Dong Y, Fan Y, Sun D. TGF-β1-containing exosomes from cardiac microvascular endothelial cells mediate cardiac fibroblast activation under high glucose conditions. Biochem Cell Biol. 2021;99:693-9.
121. Zhang Y, Zhang L, Li P, et al. Extracellular vesicles from adipose-derived stem cell alleviate diabetic cardiomyopathy by regulating Chit1/NLRP3/Caspase-1-Mediated pyroptosis. Int Immunopharmacol. 2025;146:113860.
122. Bernardo BC, Yildiz GS, Kiriazis H, et al. In vivo inhibition of miR-34a modestly limits cardiac enlargement and fibrosis in a mouse model with established type 1 diabetes-induced cardiomyopathy, but does not improve diastolic function. Cells. 2022;11:3117.
123. Rawal S, Munasinghe PE, Nagesh PT, et al. Down-regulation of miR-15a/b accelerates fibrotic remodelling in the Type 2 diabetic human and mouse heart. Clin Sci. 2017;131:847-63.
124. Chen S, Puthanveetil P, Feng B, Matkovich SJ, Dorn GW 2nd, Chakrabarti S. Cardiac miR-133a overexpression prevents early cardiac fibrosis in diabetes. J Cell Mol Med. 2014;18:415-21.
125. Zhang Y, Wang JH, Zhang YY, et al. Deletion of interleukin-6 alleviated interstitial fibrosis in streptozotocin-induced diabetic cardiomyopathy of mice through affecting TGFβ1 and miR-29 pathways. Sci Rep. 2016;6:23010.
126. Ren L, Chen X, Nie B, Qu H, Ju J, Bai Y. Ranolazine inhibits pyroptosis via regulation of miR-135b in the treatment of diabetic cardiac fibrosis. Front Mol Biosci. 2022;9:806966.
127. Wang W, Zhang S, Xu L, et al. Involvement of circHIPK3 in the pathogenesis of diabetic cardiomyopathy in mice. Diabetologia. 2021;64:681-92.
128. Ding H, Yao J, Xie H, et al. MicroRNA-195-5p downregulation inhibits endothelial mesenchymal transition and myocardial fibrosis in diabetic cardiomyopathy by targeting Smad7 and inhibiting transforming growth factor beta 1-Smads-Snail pathway. Front Physiol. 2021;12:709123.
129. Li Y, Du Y, Liu Y, et al. Cardiomyocyte-derived small extracellular vesicle: a new mechanism driving diabetic cardiac fibrosis and cardiomyopathy. Theranostics. 2024;14:5926-44.
130. Zhen J, Bai J, Liu J, Men H, Yu H. Ginsenoside RG1-induced mesenchymal stem cells alleviate diabetic cardiomyopathy through secreting exosomal circNOTCH1 to promote macrophage M2 polarization. Phytother Res. 2024;38:1745-60.
131. Chaturvedi P, Kalani A, Medina I, Familtseva A, Tyagi SC. Cardiosome mediated regulation of MMP9 in diabetic heart: role of mir29b and mir455 in exercise. J Cell Mol Med. 2015;19:2153-61.
132. Lew JK, Pearson JT, Saw E, et al. Exercise regulates microRNAs to preserve coronary and cardiac function in the diabetic heart. Circ Res. 2020;127:1384-400.
133. Zygmunciak P, Stróżna K, Błażowska O, Mrozikiewicz-Rakowska B. Extracellular vesicles in diabetic cardiomyopathy-state of the art and future perspectives. Int J Mol Sci. 2024;25:6117.
134. Aljizeeri A, Ahmed AI, Suliman I, Alfaris MA, Elneama A, Al-Mallah MH. Incremental prognostic value of positron emission tomography-derived myocardial flow reserve in patients with and without diabetes mellitus. Eur Heart J Cardiovasc Imaging. 2023;24:563-71.
135. Garcia NA, Ontoria-Oviedo I, González-King H, Diez-Juan A, Sepúlveda P. Glucose starvation in cardiomyocytes enhances exosome secretion and promotes angiogenesis in endothelial cells. PLoS One. 2015;10:e0138849.
136. Ding X, Bai G, Liu X, et al. Circulating exosomal miR-550a-5p/miR-665 identify coronary microvascular dysfunction and drive endothelial-myocyte crosstalk in type 2 diabetes. Front Cell Dev Biol. 2026;14:1744708.
137. Garg R, Rao AD, Baimas-George M, et al. Mineralocorticoid receptor blockade improves coronary microvascular function in individuals with type 2 diabetes. Diabetes. 2015;64:236-42.
138. Thomou T, Mori MA, Dreyfuss JM, et al. Adipose-derived circulating miRNAs regulate gene expression in other tissues. Nature. 2017;542:450-5.
139. Whitham M, Parker BL, Friedrichsen M, et al. Extracellular vesicles provide a means for tissue crosstalk during exercise. Cell Metab. 2018;27:237-51.e4.
140. Sljukic A, Green Jenkinson J, Niksic A, Prior N, Huch M. Advances in liver and pancreas organoids: how far we have come and where we go next. Nat Rev Gastroenterol Hepatol. 2026;23:44-64.
141. Zhang Z, Zhu D, Liu C, et al. Small extracellular vesicle external surface adiponectin-mediated adipocytes/cardiomyocytes communication in diabetic ischemic heart failure. Circulation. 2026;Epub ahead of print.
142. Ji H, Cao T, Tan Z, et al. Adipocyte extracellular vesicle mitochondrial cargo is linked to cardiomyocyte dysfunction in type 2 diabetes-related heart failure with preserved ejection fraction. Free Radic Biol Med. 2026;244:435-51.
143. Chen X, Chen S, Pang J, et al. Hepatic steatosis aggravates atherosclerosis via small extracellular vesicle-mediated inhibition of cellular cholesterol efflux. J Hepatol. 2023;79:1491-501.
144. Jing Y, Cai Y, Li Q, et al. Empagliflozin-pretreated BMSC exosomes attenuate myocardial ischemia-reperfusion injury by enhancing atad3a/pink1-dependent mitophagy. Stem Cell Res Ther. 2025;16:595.
145. Chae CW, Choi G, Yoon T, Kwon YW. Exosome-based therapy in cardiovascular diseases: a new frontier in cardiovascular disease treatment. Korean Circ J. 2025;55:461-80.






