title: Insulin resistance: an additional risk factor in the pathogenesis of cardiovascular disease in type 2 diabetes.
abstract: Sedentary life style and high calorie dietary habits are prominent leading cause of metabolic syndrome in modern world. Obesity plays a central role in occurrence of various diseases like hyperinsulinemia, hyperglycemia and hyperlipidemia, which lead to insulin resistance and metabolic derangements like cardiovascular diseases (CVDs) mediated by oxidative stress. The mortality rate due to CVDs is on the rise in developing countries. Insulin resistance (IR) leads to micro or macro angiopathy, peripheral arterial dysfunction, hampered blood flow, hypertension, as well as the cardiomyocyte and the endothelial cell dysfunctions, thus increasing risk factors for coronary artery blockage, stroke and heart failure suggesting that there is a strong association between IR and CVDs. The plausible linkages between these two pathophysiological conditions are altered levels of insulin signaling proteins such as IR-β, IRS-1, PI3K, Akt, Glut4 and PGC-1α that hamper insulin-mediated glucose uptake as well as other functions of insulin in the cardiomyocytes and the endothelial cells of the heart. Reduced AMPK, PFK-2 and elevated levels of NADP(H)-dependent oxidases produced by activated M1 macrophages of the adipose tissue and elevated levels of circulating angiotensin are also cause of CVD in diabetes mellitus condition. Insulin sensitizers, angiotensin blockers, superoxide scavengers are used as therapeutics in the amelioration of CVD. It evidently becomes important to unravel the mechanisms of the association between IR and CVDs in order to formulate novel efficient drugs to treat patients suffering from insulin resistance-mediated cardiovascular diseases. The possible associations between insulin resistance and cardiovascular diseases are reviewed here.
authors.affiliation: Molecular Endocrinology and Stem Cell Research Lab, Department of Biochemistry, Faculty of Science, The Maharaja Sayajirao University of Baroda, Vadodara, Gujarat, 390002, India.
authors.forename: Tushar P
authors.initials: TP
authors.lastname: Patel
authors.affiliation: Molecular Endocrinology and Stem Cell Research Lab, Department of Biochemistry, Faculty of Science, The Maharaja Sayajirao University of Baroda, Vadodara, Gujarat, 390002, India.
authors.forename: Komal
authors.initials: K
authors.lastname: Rawal
authors.affiliation: Department of Physiology and Pathophysiology, Faculty of Health Sciences, St. Boniface Research Centre, Institute of Cardiovascular Sciences, University of Manitoba, 351 Tache Avenue, Winnipeg, MB, R2H 2A6, Canada.
authors.forename: Ashim K
authors.initials: AK
authors.lastname: Bagchi
authors.affiliation: Department of Physiology and Pathophysiology, Faculty of Health Sciences, St. Boniface Research Centre, Institute of Cardiovascular Sciences, University of Manitoba, 351 Tache Avenue, Winnipeg, MB, R2H 2A6, Canada.
authors.forename: Gauri
authors.initials: G
authors.lastname: Akolkar
authors.affiliation: Department of Physiology and Pathophysiology, Faculty of Health Sciences, St. Boniface Research Centre, Institute of Cardiovascular Sciences, University of Manitoba, 351 Tache Avenue, Winnipeg, MB, R2H 2A6, Canada.
authors.forename: Nathalia
authors.initials: N
authors.lastname: Bernardes
authors.affiliation: Department of Physiology and Pathophysiology, Faculty of Health Sciences, St. Boniface Research Centre, Institute of Cardiovascular Sciences, University of Manitoba, 351 Tache Avenue, Winnipeg, MB, R2H 2A6, Canada.
authors.forename: Danielle da Silva
authors.initials: DDS
authors.lastname: Dias
authors.affiliation: Molecular Endocrinology and Stem Cell Research Lab, Department of Biochemistry, Faculty of Science, The Maharaja Sayajirao University of Baroda, Vadodara, Gujarat, 390002, India. sglmescrl@gmail.com.
authors.forename: Sarita
authors.initials: S
authors.lastname: Gupta
authors.affiliation: Department of Physiology and Pathophysiology, Faculty of Health Sciences, St. Boniface Research Centre, Institute of Cardiovascular Sciences, University of Manitoba, 351 Tache Avenue, Winnipeg, MB, R2H 2A6, Canada.
authors.forename: Pawan K
authors.initials: PK
authors.lastname: Singal
mesh_terms: D002318:Cardiovascular Diseases / Q000209:etiology / Q000378:metabolism; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000378:metabolism; D006801:Humans; D007328:Insulin / Q000378:metabolism*; D007333:Insulin Resistance / Q000502:physiology; D018384:Oxidative Stress; D012307:Risk Factors; D015398:Signal Transduction / Q000502:physiology
chemical_list: D007328:Insulin
keywords: CVD; Dyslipidemia; Inflammation; Insulin resistance; Metabolic syndrome; Oxidative stress