Insulin Resistance and Atherosclerosis: Implications for Insulin-Sensitizing Agents
Abstract 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 (dyslipidemia, hypertension, procoagulant state), there remains a signifi...
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| Veröffentlicht in: | Endocrine reviews 2019-12, Vol.40 (6), p.1447-1467 |
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| creator | Di Pino, Antonino DeFronzo, Ralph A |
| description | Abstract
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 (dyslipidemia, hypertension, procoagulant state), 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 (metabolic) syndrome (IRS). Considerable evidence, reviewed herein, suggests that insulin resistance and the IRS contribute to this unexplained CV risk in patients with T2DM. Accordingly, 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 the insulin-sensitizing agents and of other antihyperglycemic medications on CV outcomes are discussed. |
| doi_str_mv | 10.1210/er.2018-00141 |
| format | Article |
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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 (dyslipidemia, hypertension, procoagulant state), 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 (metabolic) syndrome (IRS). Considerable evidence, reviewed herein, suggests that insulin resistance and the IRS contribute to this unexplained CV risk in patients with T2DM. Accordingly, 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 the insulin-sensitizing agents and of other antihyperglycemic medications on CV outcomes are discussed.</description><identifier>ISSN: 0163-769X</identifier><identifier>EISSN: 1945-7189</identifier><identifier>DOI: 10.1210/er.2018-00141</identifier><identifier>PMID: 31050706</identifier><language>eng</language><publisher>Washington, DC: Endocrine Society</publisher><subject>Animals ; Arteriosclerosis ; Atherosclerosis ; Atherosclerosis - etiology ; Atherosclerosis - prevention & control ; Cardiovascular diseases ; Care and treatment ; Clinical trials ; Complications ; Complications and side effects ; Development and progression ; Diabetes mellitus ; Diabetes mellitus (non-insulin dependent) ; Diabetes Mellitus, Type 2 - complications ; Diabetes Mellitus, Type 2 - drug therapy ; Drug therapy ; Dyslipidemia ; Health risks ; Humans ; Hypertension ; Hypoglycemic agents ; Hypoglycemic Agents - pharmacology ; Hypoglycemic Agents - therapeutic use ; Insulin ; Insulin Resistance ; Pioglitazone ; Reviews ; Risk analysis ; Risk factors ; Risk groups ; Sensitizing ; Thiazolidinediones - pharmacology ; Thiazolidinediones - therapeutic use ; Type 2 diabetes</subject><ispartof>Endocrine reviews, 2019-12, Vol.40 (6), p.1447-1467</ispartof><rights>Copyright © 2019 Endocrine Society 2019</rights><rights>Copyright © Oxford University Press 2015</rights><rights>Copyright © 2019 Endocrine Society.</rights><rights>COPYRIGHT 2019 Oxford University Press</rights><rights>Copyright © 2019 Endocrine Society</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c5871-3309a69192d38656013a14edff3f8b3772f5059f05e7646248da622c90de60863</citedby><cites>FETCH-LOGICAL-c5871-3309a69192d38656013a14edff3f8b3772f5059f05e7646248da622c90de60863</cites><orcidid>0000-0003-3839-1724</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.proquest.com/docview/2365122534?pq-origsite=primo$$EHTML$$P50$$Gproquest$$H</linktohtml><link.rule.ids>230,314,776,780,881,21367,27901,27902,33721,33722,43781</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31050706$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Di Pino, Antonino</creatorcontrib><creatorcontrib>DeFronzo, Ralph A</creatorcontrib><title>Insulin Resistance and Atherosclerosis: Implications for Insulin-Sensitizing Agents</title><title>Endocrine reviews</title><addtitle>Endocr Rev</addtitle><description>Abstract
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 (dyslipidemia, hypertension, procoagulant state), 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 (metabolic) syndrome (IRS). Considerable evidence, reviewed herein, suggests that insulin resistance and the IRS contribute to this unexplained CV risk in patients with T2DM. Accordingly, 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 the insulin-sensitizing agents and of other antihyperglycemic medications on CV outcomes are discussed.</description><subject>Animals</subject><subject>Arteriosclerosis</subject><subject>Atherosclerosis</subject><subject>Atherosclerosis - etiology</subject><subject>Atherosclerosis - prevention & control</subject><subject>Cardiovascular diseases</subject><subject>Care and treatment</subject><subject>Clinical trials</subject><subject>Complications</subject><subject>Complications and side effects</subject><subject>Development and progression</subject><subject>Diabetes mellitus</subject><subject>Diabetes mellitus (non-insulin dependent)</subject><subject>Diabetes Mellitus, Type 2 - complications</subject><subject>Diabetes Mellitus, Type 2 - drug therapy</subject><subject>Drug therapy</subject><subject>Dyslipidemia</subject><subject>Health risks</subject><subject>Humans</subject><subject>Hypertension</subject><subject>Hypoglycemic agents</subject><subject>Hypoglycemic Agents - pharmacology</subject><subject>Hypoglycemic Agents - therapeutic use</subject><subject>Insulin</subject><subject>Insulin Resistance</subject><subject>Pioglitazone</subject><subject>Reviews</subject><subject>Risk analysis</subject><subject>Risk factors</subject><subject>Risk groups</subject><subject>Sensitizing</subject><subject>Thiazolidinediones - pharmacology</subject><subject>Thiazolidinediones - therapeutic use</subject><subject>Type 2 diabetes</subject><issn>0163-769X</issn><issn>1945-7189</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNp1ks9rFDEUx4Modls9epUBL71MfS-_ZuJBWIrVhYJgFbyFdCazm5pN1mTGon-9GXetVfCSkOST7_e9fEPIM4QzpAgvbTqjgG0NgBwfkAUqLuoGW_WQLAAlqxupPh-R45xvAIBDqx6TI4YgoAG5IFerkCfvQvXBZpdHEzpbmdBXy3FjU8ydn0eXX1Wr7c67zowuhlwNMVWHi_WVDdmN7ocL62q5tmHMT8ijwfhsnx7mE_Lp4s3H83f15fu3q_PlZd2JtsGaMVBGKlS0Z60UEpAZ5LYfBja016xp6CBAqAGEbSSXlLe9kZR2CnoroZXshLze6-6m663tu-KdjNe75LYmfdfROP33SXAbvY7fdMO54KiKwOlBIMWvk82j3rrcWe9NsHHKmlKqKKPFvaAv_kFv4pRCaU9TJgVSKtg9am281S4Msfh2s6heShSKApdNoeo91ZW3zckOdyUj6DlUbZOeQ9W_Qi388_t93tG_UywA3wO30Y825S9-ui0SG2v8uCkiAEwoVRdJhbSs6nkL_7Qfp93_Stj_K_YTSbe3Ew</recordid><startdate>201912</startdate><enddate>201912</enddate><creator>Di Pino, Antonino</creator><creator>DeFronzo, Ralph A</creator><general>Endocrine Society</general><general>Copyright Oxford University Press</general><general>Oxford University Press</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QG</scope><scope>7QL</scope><scope>7QP</scope><scope>7T5</scope><scope>7TK</scope><scope>7TM</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>C1K</scope><scope>CCPQU</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>H94</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>P64</scope><scope>PHGZM</scope><scope>PHGZT</scope><scope>PJZUB</scope><scope>PKEHL</scope><scope>PPXIY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>RC3</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0003-3839-1724</orcidid></search><sort><creationdate>201912</creationdate><title>Insulin Resistance and Atherosclerosis: Implications for Insulin-Sensitizing Agents</title><author>Di Pino, Antonino ; DeFronzo, Ralph A</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c5871-3309a69192d38656013a14edff3f8b3772f5059f05e7646248da622c90de60863</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Animals</topic><topic>Arteriosclerosis</topic><topic>Atherosclerosis</topic><topic>Atherosclerosis - etiology</topic><topic>Atherosclerosis - prevention & control</topic><topic>Cardiovascular diseases</topic><topic>Care and treatment</topic><topic>Clinical trials</topic><topic>Complications</topic><topic>Complications and side effects</topic><topic>Development and progression</topic><topic>Diabetes mellitus</topic><topic>Diabetes mellitus (non-insulin dependent)</topic><topic>Diabetes Mellitus, Type 2 - complications</topic><topic>Diabetes Mellitus, Type 2 - drug therapy</topic><topic>Drug therapy</topic><topic>Dyslipidemia</topic><topic>Health risks</topic><topic>Humans</topic><topic>Hypertension</topic><topic>Hypoglycemic agents</topic><topic>Hypoglycemic Agents - pharmacology</topic><topic>Hypoglycemic Agents - therapeutic use</topic><topic>Insulin</topic><topic>Insulin Resistance</topic><topic>Pioglitazone</topic><topic>Reviews</topic><topic>Risk analysis</topic><topic>Risk factors</topic><topic>Risk groups</topic><topic>Sensitizing</topic><topic>Thiazolidinediones - pharmacology</topic><topic>Thiazolidinediones - therapeutic use</topic><topic>Type 2 diabetes</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Di Pino, Antonino</creatorcontrib><creatorcontrib>DeFronzo, Ralph A</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Animal Behavior Abstracts</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Immunology Abstracts</collection><collection>Neurosciences Abstracts</collection><collection>Nucleic Acids Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest One Community College</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest Central (New)</collection><collection>ProQuest One Academic (New)</collection><collection>ProQuest Health & Medical Research Collection</collection><collection>ProQuest One Academic Middle East (New)</collection><collection>ProQuest One Health & Nursing</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>Genetics Abstracts</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Endocrine reviews</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Di Pino, Antonino</au><au>DeFronzo, Ralph A</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Insulin Resistance and Atherosclerosis: Implications for Insulin-Sensitizing Agents</atitle><jtitle>Endocrine reviews</jtitle><addtitle>Endocr Rev</addtitle><date>2019-12</date><risdate>2019</risdate><volume>40</volume><issue>6</issue><spage>1447</spage><epage>1467</epage><pages>1447-1467</pages><issn>0163-769X</issn><eissn>1945-7189</eissn><abstract>Abstract
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 (dyslipidemia, hypertension, procoagulant state), 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 (metabolic) syndrome (IRS). Considerable evidence, reviewed herein, suggests that insulin resistance and the IRS contribute to this unexplained CV risk in patients with T2DM. Accordingly, 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 the insulin-sensitizing agents and of other antihyperglycemic medications on CV outcomes are discussed.</abstract><cop>Washington, DC</cop><pub>Endocrine Society</pub><pmid>31050706</pmid><doi>10.1210/er.2018-00141</doi><tpages>21</tpages><orcidid>https://orcid.org/0000-0003-3839-1724</orcidid><oa>free_for_read</oa></addata></record> |
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| ispartof | Endocrine reviews, 2019-12, Vol.40 (6), p.1447-1467 |
| issn | 0163-769X 1945-7189 |
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| source | Oxford University Press Journals All Titles (1996-Current); MEDLINE; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Alma/SFX Local Collection; ProQuest Central |
| subjects | Animals Arteriosclerosis Atherosclerosis Atherosclerosis - etiology Atherosclerosis - prevention & control Cardiovascular diseases Care and treatment Clinical trials Complications Complications and side effects Development and progression Diabetes mellitus Diabetes mellitus (non-insulin dependent) Diabetes Mellitus, Type 2 - complications Diabetes Mellitus, Type 2 - drug therapy Drug therapy Dyslipidemia Health risks Humans Hypertension Hypoglycemic agents Hypoglycemic Agents - pharmacology Hypoglycemic Agents - therapeutic use Insulin Insulin Resistance Pioglitazone Reviews Risk analysis Risk factors Risk groups Sensitizing Thiazolidinediones - pharmacology Thiazolidinediones - therapeutic use Type 2 diabetes |
| title | Insulin Resistance and Atherosclerosis: Implications for Insulin-Sensitizing Agents |
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