Insulin resistance: an independent risk factor for cardiovascular disease?
Population-based studies have shown that patients with type 2 diabetes have a higher cardiovascular morbidity and mortality and an increased all-cause mortality compared with non-diabetic subjects. In non-diabetic subjects, hyperinsulinaemia not only has been associated with an increased cardiovascular risk, but is also related with a number of other cardiovascular risk factors--hyperglycaemia, hypertension, dyslipidaemia, and a central body fat distribution--that constitute the insulin resistance syndrome and are also characteristic of type 2 diabetes. After 23 years of follow-up in the Paris Prospective Study, both fasting and 2-h insulin concentrations were related with all-cause mortality in a U-shaped fashion, with low and high concentrations being associated with an increased risk, independently of other risk factors; in contrast, while high insulin levels carried an increased risk for cardiovascular and coronary heart disease mortality, this was not independent of other risk factors.
Balkau
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INSERM Unit 258, Villejuif, France. balkau@vjf.inserm.fr
Eschwège
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D001823:Body Composition; D002318:Cardiovascular Diseases / Q000209:etiology* / Q000401:mortality; D003924:Diabetes Mellitus, Type 2 / Q000150:complications; D006801:Humans; D006943:Hyperglycemia / Q000150:complications; D006946:Hyperinsulinism / Q000150:complications; D006949:Hyperlipidemias / Q000150:complications; D006973:Hypertension / Q000150:complications; D007333:Insulin Resistance; D011446:Prospective Studies; D012307:Risk Factors; D013577:Syndrome