Insulin resistance and atherosclerosis: implications for insulin-sensitizing agents

Česká verzia

Authors: Jan Škrha Jr
Authors place of work: III. interní klinika – klinika endokrinologie a metabolismu 1. LF UK a VFN v Praze
Published in the journal: AtheroRev 2020; 5(1): 33-36
Category:

Summary

Patients with type 2 diabetes mellitus (T2DM) are at high risk for macrovascular complications, which represent the major cause of mortality. Despite effective treatment of established cardiovascular (CV) risk factors, there remains a significant amount of unexplained CV risk. Insulin resistance is associated with a cluster of cardiometabolic risk factors known collectively as the insulin resistance syndrome (IRS). Considerable evidence suggests that insulin resistance and the IRS contribute to this unexplained CV risk. CV outcome trials with pioglitazone have demonstrated that this insulin-sensitizing thiazolidinedione reduces CV events in high-risk patients with T2DM. In this review the roles of insulin resistance and the IRS in the development of atherosclerotic CV disease and the impact of antihyperglycemic medications on CV outcomes are discussed.

Keywords:

insulin resistance – cardiovascular risk – macrovascular complications – pioglitazone – type 2 diabetes mellitus

Zdroje

Gast KB, Tjeerdema N, Stijnen T et al. Insulin resistance and risk of incident cardiovascular events in adults without diabetes: meta-analysis. PLoS One 2012; 7(12): e52036. Dostupné z DOI: <http://dx.doi.org/10.1371/journal.pone.0052036>.
Ferrannini E, Balkau B, Coppack SW et al. Insulin resistance, insulin response, and obesity as indicators of metabolic risk. J Clin Endocrinol Metab 2007; 92(8): 2885–2892. Dostupné z DOI: <http://dx.doi.org/10.1210/jc.2007–0334>.
Haffner SM, Lehto S, Rönnemaa T et al. Mortality from coronary heart disease in subjects with type 2 diabetes and in nondiabetic subjects with and without prior myocardial infarction. N Engl J Med 1998; 339(4): 229–234. Dostupné z DOI: <http://dx.doi.org/10.1056/NEJM199807233390404>.
D‘Agostino RB sr, Grundy S, Sullivan LM et al. Validation of the Framingham coronary heart disease prediction scores: results of a multiple ethnic groups investigation. JAMA 2001; 286(2): 180–187. Dostupné z DOI: <http://dx.doi.org/10.1001/jama.286.2.180>.
Rawshani A, Rawshani A, Franzén S et al. Mortality and Cardiovascular Disease in Type 1 and Type 2 Diabetes. N Engl J Med 2017; 376(15): 1407–1418. Dostupné z DOI: <http://dx.doi.org/10.1056/NEJMoa1608664>.
Rao Kondapally Seshasai S, Kaptoge S, Thompson A et al. Diabetes mellitus, fasting glucose, and risk of cause-specific death. N Engl J Med 2011; 364(9): 829–841. Dostupné z DOI: <http://dx.doi.org/10.1056/NEJMoa1008862>.
Dansinger ML, Tatsioni A, Wong JB et al. Meta-analysis: the effect of dietary counseling for weight loss. Ann Intern Med 2007; 147(1): 41–50. Dostupné z DOI: <http://dx.doi.org/10.7326/0003–4819–147–1-200707030–00007>.
Anderson JW, Konz EC, Frederich RC et al. Long-term weight-loss maintenance: a meta-analysis of US studies. Am J Clin Nutr 2001; 74(5): p. 579–584. Dostupné z DOI: <http://dx.doi.org/10.1093/ajcn/74.5.579>.
Kastorini CM, Milionis HJ, Esposito K et al. The effect of Mediterranean diet on metabolic syndrome and its components: a meta-analysis of 50 studies and 534,906 individuals. J Am Coll Cardiol 2011; 57(11): 1299–1313. Dostupné z DOI: <http://dx.doi.org/10.1016/j.jacc.2010.09.073>.
Dormandy JA, Charbonnel B, Eckland DJ et al. Secondary prevention of macrovascular events in patients with type 2 diabetes in the PROactive Study (PROspective pioglitAzone Clinical Trial In macroVascular Events): a randomised controlled trial. Lancet 2005; 366(9493): 1279–1289. Dostupné z DOI: <http://dx.doi.org/10.1016/S0140–6736(05)67528–9>.
Lewis JD, Habel LA, Quesenberry CP et al. Pioglitazone Use and Risk of Bladder Cancer and Other Common Cancers in Persons With Diabetes. JAMA 2015; 314(3): 265–277. Dostupné z DOI: <http://dx.doi.org10.1001/jama.2015.7996>.
Griffin SJ, Leaver JK, Irving GJ. Impact of metformin on cardiovascular disease: a meta-analysis of randomised trials among people with type 2 diabetes. Diabetologia 2017; 60(9): 1620–1629. Dostupné z DOI: <http://dx.doi.org/10.1007/s00125–017–4337–9>.
DeFronzo RA. Combination therapy with GLP-1 receptor agonist and SGLT2 inhibitor. Diabetes Obes Metab 2017; 19(10): 1353–1362. Dostupné z DOI: <http://dx.doi.org/10.1111/dom.12982>.
Di Pino A, DeFronzo RA. Insulin Resistance and Atherosclerosis: Implications for Insulin-Sensitizing Agents. Endocr Rev 2019; 40(6):1447–1467. Dostupné z DOI: <http://dx.doi.org/10.1210/er.2018–00141>.