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 insulinaction were initially proposed as the common preceding factorsof hypertension, low high-density lipoprotein cholesterol, hypertriglyceridemia,abdominal obesity, and altered glucose tolerance, linking allthese abnormalities to the development of coronary heart disease.The similarities of insulin resistance with another inflammatorystate, atherosclerosis, have been described only in the lastfew decades. Atherosclerosis and insulin resistance share similarpathophysiological mechanisms, mainly due to the actions ofthe two major proinflammatory cytokines, TNF- and IL-6. Geneticpredisposition to increased transcription rates of these cytokinesis associated with metabolic derangement and simultaneouslywith coronary heart disease. Dysregulation of the inflammatoryaxis predicts the development of insulin resistance and type2 diabetes mellitus. The knowledge of how interactions betweenmetabolic and inflammatory pathways occur will be useful infuture therapeutic strategies. The effective administrationof antiinflammatory agents in the treatment of insulin resistanceand atherosclerosis is only the beginning of a promising approachin the management of these syndromes.
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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
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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
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[Abstract][Full Text][PDF]
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
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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
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E. E. Kershaw and J. S. Flier Adipose Tissue as an Endocrine Organ
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B. J. Goldstein and R. Scalia Adiponectin: A Novel Adipokine Linking Adipocytes and Vascular Function
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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
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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
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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
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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
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R. A. Velliquette and P. Ernsberger Contrasting Metabolic Effects of Antihypertensive Agents
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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. 
