Perlecan levels are decreased in many disease states - e.g., diabetes, atherosclerosis and arthritis. Perlecan has an important role in the maintenance of the glomerular filtration barrier. Decreased perlecan in the glomerular basement membrane has a central role in the development of diabetic albuminuria. Perlecan expression is down regulated by many atherogenic stimuli and thus Perlecan is thought to play a protective role in atherosclerosis. Diabetes and atherosclerosis are commonly associated syndromes. 80% of diabetes-associated deaths involve some form of atherosclerotic complication, and the basement membrane of endothelia has been implicated in the atherogenic process. Synthesis of heparan sulfate was shown to decrease in the arteries of diabetics and in arteries developing atherosclerotic lesions.