SIRT1 and Hyperglycemia: Hyperglycemia and an imbalance in mineral ion homeostasis lead to endothelial cell injury. The medial mucosal layer responds by triggering the repair response. CVCs perceive extracellular signals, upregulate osteogenic factors, downregulate sirtuin-1, and activate Wnt signaling, resulting in CVC differentiation into osteogenic cells and promoting vascular calcification