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Endocrine Reviews 24 (3): 278-301
Copyright © 2003 by The Endocrine Society

Insulin Resistance and Chronic Cardiovascular Inflammatory Syndrome

José Manuel Fernández-Real and Wifredo Ricart

Section of Diabetes, Endocrinology and Nutrition, University Hospital of Girona "Dr. Josep Trueta," 17007 Girona, Spain

Correspondence: Address all correspondence and requests for reprints to: J. M. Fernández-Real, M.D., Ph.D., Unitat de Diabetes, Endocrinologia i Nutrició., Hospital de Girona "Dr. Josep Trueta", Carretera de Francia s/n, 17007 Girona, Spain. E-mail: uden.jmfernandezreal{at}htrueta.scs.es

Insulin resistance is increasingly recognized as a chronic, low-level, inflammatory state. Hyperinsulinemia and insulin action were initially proposed as the common preceding factors of hypertension, low high-density lipoprotein cholesterol, hypertriglyceridemia, abdominal obesity, and altered glucose tolerance, linking all these abnormalities to the development of coronary heart disease. The similarities of insulin resistance with another inflammatory state, atherosclerosis, have been described only in the last few decades. Atherosclerosis and insulin resistance share similar pathophysiological mechanisms, mainly due to the actions of the two major proinflammatory cytokines, TNF-{alpha} and IL-6. Genetic predisposition to increased transcription rates of these cytokines is associated with metabolic derangement and simultaneously with coronary heart disease. Dysregulation of the inflammatory axis predicts the development of insulin resistance and type 2 diabetes mellitus. The knowledge of how interactions between metabolic and inflammatory pathways occur will be useful in future therapeutic strategies. The effective administration of antiinflammatory agents in the treatment of insulin resistance and atherosclerosis is only the beginning of a promising approach in the management of these syndromes.




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Inflammation, Insulin Resistance, and Glucose Intolerance in Acute Myocardial Infarction Patients without a Previous Diagnosis of Diabetes Mellitus
J. Clin. Endocrinol. Metab., January 1, 2005; 90(1): 175 - 180.
[Abstract] [Full Text] [PDF]

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 J. Am. Soc. Nephrol.Home page
S. P. Bagby
Obesity-Initiated Metabolic Syndrome and the Kidney: A Recipe for Chronic Kidney Disease?
J. Am. Soc. Nephrol., November 1, 2004; 15(11): 2775 - 2791.
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 EndocrinologyHome page
H. Lu, M. Raptis, E. Black, M. Stan, S. Amar, and D. T. Graves
Influence of Diabetes on the Exacerbation of an Inflammatory Response in Cardiovascular Tissue
Endocrinology, November 1, 2004; 145(11): 4934 - 4939.
[Abstract] [Full Text] [PDF]

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 EndocrinologyHome page
M. Kudo, A. Sugawara, A. Uruno, K. Takeuchi, and S. Ito
Transcription Suppression of Peroxisome Proliferator-Activated Receptor {gamma}2 Gene Expression by Tumor Necrosis Factor {alpha} via an Inhibition of CCAAT/ Enhancer-binding Protein {delta} during the Early Stage of Adipocyte Differentiation
Endocrinology, November 1, 2004; 145(11): 4948 - 4956.
[Abstract] [Full Text] [PDF]

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 JAMAHome page
K. Esposito, R. Marfella, M. Ciotola, C. Di Palo, F. Giugliano, G. Giugliano, M. D'Armiento, F. D'Andrea, and D. Giugliano
Effect of a Mediterranean-Style Diet on Endothelial Dysfunction and Markers of Vascular Inflammation in the Metabolic Syndrome: A Randomized Trial
JAMA, September 22, 2004; 292(12): 1440 - 1446.
[Abstract] [Full Text] [PDF]

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 Clin. Chem.Home page
J. M. Fernandez-Real, A. Lopez-Bermejo, M. Broch, J. Vendrell, C. Richart, and W. Ricart
Circulating Soluble CD14 Monocyte Receptor Is Associated with Increased Alanine Aminotransferase
Clin. Chem., August 1, 2004; 50(8): 1456 - 1458.
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 J. Biol. Chem.Home page
C. Weigert, K. Brodbeck, H. Staiger, C. Kausch, F. Machicao, H. U. Haring, and E. D. Schleicher
Palmitate, but Not Unsaturated Fatty Acids, Induces the Expression of Interleukin-6 in Human Myotubes through Proteasome-dependent Activation of Nuclear Factor-{kappa}B
J. Biol. Chem., June 4, 2004; 279(23): 23942 - 23952.
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 J. Clin. Endocrinol. Metab.Home page
E. E. Kershaw and J. S. Flier
Adipose Tissue as an Endocrine Organ
J. Clin. Endocrinol. Metab., June 1, 2004; 89(6): 2548 - 2556.
[Abstract] [Full Text] [PDF]

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 J. Clin. Endocrinol. Metab.Home page
B. J. Goldstein and R. Scalia
Adiponectin: A Novel Adipokine Linking Adipocytes and Vascular Function
J. Clin. Endocrinol. Metab., June 1, 2004; 89(6): 2563 - 2568.
[Abstract] [Full Text] [PDF]

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 DiabetesHome page
M. Straczkowski, I. Kowalska, A. Nikolajuk, S. Dzienis-Straczkowska, I. Kinalska, M. Baranowski, M. Zendzian-Piotrowska, Z. Brzezinska, and J. Gorski
Relationship Between Insulin Sensitivity and Sphingomyelin Signaling Pathway in Human Skeletal Muscle
Diabetes, May 1, 2004; 53(5): 1215 - 1221.
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 J. Lipid Res.Home page
G. E. Sonnenberg, G. R. Krakower, L. J. Martin, M. Olivier, A. E. Kwitek, A. G. Comuzzie, J. Blangero, and A. H. Kissebah
Genetic determinants of obesity-related lipid traits
J. Lipid Res., April 1, 2004; 45(4): 610 - 615.
[Abstract] [Full Text] [PDF]

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 Diabetes CareHome page
J.-M. Fernandez-Real, A. Castro, G. Vazquez, R. Casamitjana, A. Lopez-Bermejo, G. Penarroja, and W. Ricart
Adiponectin Is Associated With Vascular Function Independent of Insulin Sensitivity
Diabetes Care, March 1, 2004; 27(3): 739 - 745.
[Abstract] [Full Text] [PDF]

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 J. Clin. Endocrinol. Metab.Home page
H. F. Escobar-Morreale, J. I. Botella-Carretero, G. Villuendas, J. Sancho, and J. L. San Millan
Serum Interleukin-18 Concentrations Are Increased in the Polycystic Ovary Syndrome: Relationship to Insulin Resistance and to Obesity
J. Clin. Endocrinol. Metab., February 1, 2004; 89(2): 806 - 811.
[Abstract] [Full Text] [PDF]

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 J. Pharmacol. Exp. Ther.Home page
R. A. Velliquette and P. Ernsberger
Contrasting Metabolic Effects of Antihypertensive Agents
J. Pharmacol. Exp. Ther., December 1, 2003; 307(3): 1104 - 1111.
[Abstract] [Full Text] [PDF]


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