Does insulin resistance adversely affect the cardiovascular system?
Insulin resistance causes a constellation of abnormalities that affect both glucose metabolism and the tendency to develop Type 2 diabetes, as well as abnormalities in endothelial function and other factors that contribute to the development of cardiovascular disease. In fact, CVD is the leading cause of death in persons with diabetes, most of whom have insulin resistance. Insulin resistance is driven to a large extent by visceral obesity, which affects insulin action in its metabolic tissues as well as vascular endothelial function. Changes in several circulating factors secreted from adipose tissue contribute to vascular dysfunction, including increases in free fatty acids (FFA); increases in cytokines, such as tumor necrosis factor (TNF)-_, interleukin (IL)-6, and plasminogen activator inhibitor-1 (PAI-I); and decreases in other proteins, such as adiponectin. These changes render the endothelial cells less capable of secreting nitric oxide (NO); this result in vascular “stiffness,”
