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Also increases LPL activity (increased catabolism of circulating TGs increases the rate of clearance of TG) by both transcription upregulation of LPL and down regulation of APOC3 (an inhibitor of LPL) [136, 137]

In addition, ROS are also produced as by-products of several cellular enzymes, such as nicotinamide adenine dinucleotide phosphate oxidases (NOXs), xanthine oxidoreductase (XOR), and lipoxygenases (LOXs)

Polymorphisms of the methylenetetrahydrofolate reductase (MTHFR) gene lead to reduced methylation, elevation of Hcy, reduction of nitric oxide, microvascular disease- particularly capillary endothelial injury and apoptosis, microaneurysms, leakage, ischemia, retinal atrophy, neovascularization, and vision loss [22]