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The British Journal of Diabetes & Vascular Disease
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Insulin resistance and cardiovascular disease

Markku Laakso

Department of Medicine, University of Kuopio, Kuopio 70210, Finland, markku.laakso{at}kuh.fi

Insulin resistance is characterised by a decreased rate of insulin-mediated glucose uptake and is associated with adverse changes in cardiovascular risk factors, such as high triglyceride levels, low levels of high-density lipoprotein cholesterol, raised blood pressure, obesity and increased levels of plasminogen activator inhibitor 1. The term `insulin resistance syndrome' (IRS) is used to describe the complex of factors associated with insulin resistance that is found in patients both with and without type 2 diabetes. Although the presence of insulin resistance syndrome is generally considered to be a risk factor for cardiovascular disease, there is a lack of definitive evidence for a causal link. Recently, however, a statistical method known as factor analysis has been applied to the cluster of cardiovascular risk factors associated with IRS. This has been able to show that the `insulin resistance factor' (high plasma insulin and glucose levels, body mass index, waist-to-hip ratio and triglyceride levels) predicted coronary heart disease events in elderly non-diabetic men as well as in patients with type 2 diabetes. Therefore, treatment of insulin resistance whether by pharmacological (eg. thiazolidinediones) or nonpharmacological means has the potential to offer both improvements in glycaemic control and in cardiovascular events.

Key Words: diabetes • cardiovascular disease • cluster analysis • insulin resistance • lipid metabolism.

The British Journal of Diabetes & Vascular Disease, Vol. 2, No. 1 suppl, S9-S11 (2002)
DOI: 10.1177/14746514020020010301
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