Myocardial Insulin Resistance and Cardiac Complications of Diabetes
Authors E. Dale Abel
Submitted By E. Dale Abel on 8/5/2005
Status Published
Journal Current drug targets. Immune, endocrine and metabolic disorders
Year 2005
Date Published 6/1/2005
Volume : Pages 5 : 219 - 226
PubMed Reference 16089356
Abstract Cardiovascular disease is a major cause of mortality and morbidity in
individuals with obesity, type 2 diabetes and the metabolic syndrome. The
mechanisms for this are partially understood, but include increased
atherosclerosis. hypercoagulability and increased hypertension. Epidemiological
data suggests however, that a omponent of the excess cardiovascular mortality
occurs independently of underlying coronary artery disease. Indeed, diabetes is
an independent risk factor for the development of heart failure and the
mechanisms responsible remain to be clarified. lnsulin resistance in skeletal
muscle, adipose tissue and the liver are widely ecognized features of obesity
and type 2 diabetes, and contribute to the pathogenesis of impaired glucose
homeostasis. Insulin resistance has also been described in the vasculature, and
may conbibute to endothelial dysfunction and atherosclerosis. The heart is an
insulin responsive organ and less is known about whether or not the heart
becomes insulin resistant in diabetes and what the pathogenic consequences of
this might be. This review will discuss the currently vailable evidence from
human and animal studies, that the heart may become insulin resistant in obesity
and type 2 diabetes. The potential consequences of this on cardiac structure,
function and metabolism will be discussed as well as recent data from transgenic
mice with perturbed cardiac insulin sensitivity that have shed interesting new
insight into potential mechanisms linking cardiac insulin resistance with
myocardial dysfunction in diabetes.