Association between insulin resistance and the development of cardiovascular disease

作者：Valeska Ormazábal, Soumyalekshmi Nair, Omar Elfeky, Claudio Aguayo, Carlos Salomón, Felipe Zúñiga · 发表于：Cardiovascular Diabetology · 年份：2018 · DOI：10.1186/s12933-018-0762-4 · 被引用次数：2455 · 研究领域：Cardiovascular Function and Risk Factors、Adipose Tissue and Metabolism、Diabetes, Cardiovascular Risks, and Lipoproteins

For many years, cardiovascular disease (CVD) has been the leading cause of death around the world. Often associated with CVD are comorbidities such as obesity, abnormal lipid profiles and insulin resistance. Insulin is a key hormone that functions as a regulator of cellular metabolism in many tissues in the human body. Insulin resistance is defined as a decrease in tissue response to insulin stimulation thus insulin resistance is characterized by defects in uptake and oxidation of glucose, a decrease in glycogen synthesis, and, to a lesser extent, the ability to suppress lipid oxidation. Literature widely suggests that free fatty acids are the predominant substrate used in the adult myocardium for ATP production, however, the cardiac metabolic network is highly flexible and can use other substrates, such as glucose, lactate or amino acids. During insulin resistance, several metabolic alterations induce the development of cardiovascular disease. For instance, insulin resistance can induce an imbalance in glucose metabolism that generates chronic hyperglycemia, which in turn triggers oxidative stress and causes an inflammatory response that leads to cell damage. Insulin resistance can also alter systemic lipid metabolism which then leads to the development of dyslipidemia and the well-known lipid triad: (1) high levels of plasma triglycerides, (2) low levels of high-density lipoprotein, and (3) the appearance of small dense low-density lipoproteins. This triad, along with endot...