Because hyperglycemia-induced accumulation of AGE also promotes VCAM-1-dependent recruitment of leukocytes [35], our data strongly suggest that the synergistic effects of glucotoxicity and lipotoxicity potentially contribute to macrophage infiltration, endothelial dysfunction, and smooth muscle cell proliferation within fibrous caps, all of which may accelerate advanced plague formation in diabetes. Here, VCAM1 is linked to endothelial dysfunction.