Pre-diabetes, insulin resistance, inflammation and CVD risk.
There is accumulating evidence that insulin resistance in the pre-diabetic state is associated with the presence of additional cardiovascular risk factors and increased incidence of cardiovascular disease (CVD). There is also accumulating evidence indicating that chronic sub-clinical inflammation as measured by such inflammatory markers as C-reactive protein (CRP) is associated with insulin resistance and other features of the insulin resistance syndrome, increased risk of development of type 2 diabetes and increased cardiovascular event risk. Insulin-sensitizing agents may have greater effects in reducing cardiovascular risk than secretagogues in the pre-diabetic state, and glitazones have been found to decrease CRP levels in patients with diabetes. Statins also reduce CRP levels. Efforts to reduce CVD should include increased emphasis on improving glycaemic control, preventing development of diabetes and addressing cardiovascular risk factors in the pre-diabetic state.
Haffner
Steven M
SM
Department of Medicine, Division of Clinical Epidemiology, University of Texas Health Science Center at San Antonio, DTL, Room 5.606U, Mail code 7873, 7703 Floyd Curl Drive, San Antonio, TX 78229-3900, USA. haffner@uthscsa.edu
D000367:Age Factors; D015415:Biomarkers / Q000032:analysis; D002097:C-Reactive Protein / Q000378:metabolism; D002318:Cardiovascular Diseases / Q000097:blood / Q000209:etiology* / Q000517:prevention & control; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000188:drug therapy / Q000209:etiology; D018450:Disease Progression; D006801:Humans; D007249:Inflammation / Q000097:blood / Q000150:complications / Q000378:metabolism; D007333:Insulin Resistance / Q000502:physiology*; D011236:Prediabetic State / Q000097:blood / Q000150:complications / Q000378:metabolism*; D012307:Risk Factors; D000077154:Rosiglitazone; D012737:Sex Factors; D045162:Thiazolidinediones / Q000627:therapeutic use
D015415:Biomarkers; D045162:Thiazolidinediones; D000077154:Rosiglitazone; D002097:C-Reactive Protein