Insulin resistance as an independent risk factor of cardiovascular diseases

An article is dedicated to the problem of insulin resistance (IR), considered as an independent risk factor of cardiovascular diseases now. Pathophysiological mechanisms, involved in cardiovascular damage, are presented: endothelial dysfunction, oxidative stress, chronic inflammation, lipotoxicity, dyslipidemia, arterial hypertension, left ventricular hypertrophy, kidney damage. Various diagnostic methods of IR, their scientific and practical significance are presented, in particular the EHC-test, index HOMA-IR, index Matsuda, QUICKI, index F. Caro, Adipo-IR, TyGindex. Special attention is paid to the screening of IR. The directions of pharmacotherapy of IR syndrome are also described.

References

1. Скибчик В.А. (2006) Інсулінорезистентність: клінічне значення, методи визначення, підходи до лікування. Укр. мед. часопис, 6: 61–68.
2. Fazio S., Mercurio V., Tibullo L. et al. (2024) Insulin resistance/hyperinsulinemia: an important cardiovascular risk factor that has long been underestimated. Front. Cardiovasc. Med., 11: 1380506. doi: 10.3389/fcvm.2024.1380506.
3. Towler M.C., Hardie D.G. (2007) AMP-activated protein kinase in metabolic control and insulin signaling. Circ. Res., 100: 328–41.
4. Bierman E.L. (1992) George Lyman Duff Memorial Lecture. Atherogenesis in diabetes. Arterioscler. Thromb., 12: 647–656.
5. Alfaddagh A., Martin S.S., Leucker T.M. et al. (2020) Inflammation and cardiovascular disease: from mechanisms to therapeutics. Am. J. Prev. Cardiol., 4: 100130.
6. Скибчик В.А. (2007) Інсулінорезистентність та системне запалення у хворих на гострий інфаркт міокарда і цукровий діабет 2–го типу: клінічне значення. Укр. мед. часопис, 2(58): 72–77.
7. Landsberg L. (1996) Insulin and the sympathetic nervous system in the pathophysiology of hypertension. Blood Press Suppl., 1: 25–9.
8. Masaki N., Feng B., Bretón-Romero R. et al. (2020) O-GlcNAcylation mediates glucose-induced alterations in endothelial cell phenotype in human diabetes mellitus. J. Am. Heart Assoc., 9: e014046.
9. Serafidis P.A., Ruilope L.M. (2006) Insulin resistance, hyperinsulinemia, and renal injury: mechanisms and implications. Am. J. Nephrol., 26(3): 232–344.
10. Ohya Y., Abeb I., Fujii K. et al. (1996) Hyperinsulinemia and left ventricular geometry in a work-site population in Japan. Hypertension, 27: 729–734.
11. Shah R.V., Abbasi S.A., Heydari B. et al. (2013) Insulin resistance, subclinical left ventricular remodeling, and the obesity paradox: MESA (multi-ethnic study of atherosclerosis). J. Am. Coll. Cardiol., 61(16): 1698–1706.
12. AlZadjali M.A., Godfrey V., Khan F. et al. (2009) Insulin resistance is highly prevalent and is associated with reduced exercise tolerance in nondiabetic patients with heart failure. J. Am. Coll. Cardiol., 53(9): 747–753.
13. Sasaki N., Ueno Yoshitaka, Higashi Yukihito. (2024) Indicators of insulin resistance in clinical practice. Hypertens. Res., 47(4): 877–886.
14. DeFronzo R., Tobin J., Andres R. (1979) Glucose clamp technique: a method for quantifying insulin secretion and resistance. Am. J. Physiol., 237(3): E214–E223.
15. Andres R., Swerdloff R., Pozefsky T., Coleman D. (1966) Manual feedback technique for the control of glucose concentration. In: Jr.L.T. Skeggs (Ed.) Automation in analytic chemistry. Medaid, New York, 486–491.
16. Matthews D.R., Hosker J.P., Rudenski A.S. et al. (1985) Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia, 28(7): 412–419.
17. Matsuda M., DeFronzo R.A. (1999) Insulin sensitivity indices obtained from oral glucose tolerance testing: comparison with the euglycemic insulin clamp. Diabetes Care, 22: 1462–1470.
18. Katz A., Nambi S.S., Mather K. et al. (2000) Quantitative insulin sensitivity check index: a simple, accurate method for assessing insulin sensitivity in humans. J. Clin. Endocrinol. Metab., 85(7): 2402–2410.
19. Caro F. (1991) Clinical review 26: Insulin resistance in obese and nonobese man. J. Clin. Endocrinol. Metab., 73(4): 691–695.
20. Semnani-Azad Z., Connelly P.W., Bazinet R.P. et al. (2021) Adipose tissue insulin resistance is longitudinally associated with adipose tissue dysfunction, circulating lipids, and dysglycemia: the PROMISE cohort. Diabetes Care, 44(7): 1682–1691.
21. Tao L.C., Xu J.N., Wang T.T. et al. (2022) Triglyceride-glucose index as a marker in cardiovascular diseases: landscape and limitations. Cardiovasc. Diabetol., 21: 68.
22. Yang Y., Zhao C., Ye Y., Yu M., Qu X. (2020). Prospect of Sodium–Glucose Co-transporter 2 Inhibitors Combined With Insulin for the Treatment of Type 2 Diabetes. Front Endocrinol (Lausanne), 15(11): 190. doi: 10.3389/fendo.2020.00190.
23. Shimo N., Matsuoka T.A., Miyatsuka T. et al. (2015) Short-term selective alleviation of glucotoxicity and lipotoxicity ameliorates the suppressed expression of key beta-cell factors under diabetic conditions. Biochem. Biophys. Res. Commun., 467: 948–954.
24. Mashayekhi M., Nian H., Mayfield D. et al. (2023) Weight Loss-Independent Effect of Liraglutide on Insulin Sensitivity in Individuals With Obesity and Prediabetes.
25. Salvatore T., Galiero R., Caturano A. et al. (2021) Effects of metformin in heart failure: from pathophysiological rationale to clinical evidence. Biomolecules, 11(12): 1834.
26. Miczke A., Sulisburska J., Pupek-Musialik D. et al. (2015) Effect of L-arginine supplementation on insulin resistance and serum adiponectin concentration in rats with far diet. Int. J. Clin. Exp. Med., 8(7): 10358–10366.
27. Lucotti P., Setola E., Monti L.D. et al. (2006) Beneficial effects of a long-term oral L-arginine treatment added to a hypocaloric diet and exercise training program in obese, insulin-resistant type 2 diabetic patients. Am. J. Physiol. Endocrinol. Metab., 291(5): E906– E912.