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Chronic fluctuations in blood glucose not only trigger oxidative stress but also promote the accumulation of advanced glycation end products (AGEs), exacerbating iron overload and lipid peroxidation ( Hyperglycemia promotes ferroptosis in myocardial cells through several interrelated mechanisms, which collectively contribute to the progression of DCM

doi: 10.1016/j.scitotenv.2020.144107 15

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NET components degrade the endothelial glycocalyx, impair shearstress-mediated eNOS activation, and increase endothelial permeability, thereby exposing the subendothelial matrix and activating platelets [86]