Pathophysiology and treatment of the dyslipidemia of insulin resistance

被引：18

作者：

Cohn G. ^{[1
]}

Valdes G. ^{[1
]}

Capuzzi D.M. ^{[1
]}

机构：

[1] Cleveland Clinic Florida, Weston, FL 33331

来源：

Current Cardiology Reports | 2001年 / 3卷 / 5期

关键词：

Insulin Resistance; Metformin; Gemfibrozil; Orlistat; Insulin Resistance Syndrome;

D O I：

10.1007/s11886-001-0059-0

中图分类号：

学科分类号：

摘要：

Insulin resistance, and the compensatory hyperinsulinemia that results, has been linked to a host of defects including glucose intolerance, diabetes, hypertension, dyslipidemia, endothelial dysfunction, impaired fibrinolysis, and subclinical inflammation. Patients with this metabolic syndrome have a markedly increased risk for the development of atherothrombotic cardiovascular disease. The characteristic dyslipidemia of insulin resistance consists of elevated triglyceride and triglyceride-rich lipoprotein levels, low levels of high-density lipoprotein cholesterol, and increased concentrations of small, dense low-density lipoprotein cholesterol. Management of this dyslipidemia typically involves a dual approach. Lifestyle modification is an essential component of any successful treatment plan, but alone is usually insufficient to correct these lipoprotein abnormalities. Medications that diminish insulin resistance and directly alter lipoproteins are also necessary in the majority of cases. Combinations of therapeutic agents are often required to optimize attainment of treatment goals. Copyright © 2001 by Current Science Inc..

引用

页码：416 / 423

页数：7

共 43 条

[1] Haffner S.M., Lehto S., Ronnemaa T., Et al., Mortality from coronary heart disease in subjects with type 2 diabetes and in nondiabetic subjects with and without prior myocardial infarction, New Engl J Med, 339, pp. 229-234, (1998)
[2] Dagogo-Jack S., Santiago J.V., Pathophysiology of type 2 diabetes and modes of action of therapeutic interventions, Arch Int Med, 103, pp. 1802-1817, (1997)
[3] Eschwege E., Richard J.L., Thibult N., Et al., Coronary heart disease mortality in relation with diabetes, blood glucose and plasma insulin levels: The Paris prospective study, ten years later, Horm Metab Res, 15, SUPPL., pp. 41-46, (1985)
[4] Despres J.P., Lamarche B., Mauriege P., Et al., Hyperinsulinemia as an independent risk factor for ischemic heart disease, New Engl J Med, 334, pp. 952-957, (1996)
[5] Haffner S.M., Miettinen H., Insulin resistance implications for type II diabetes mellitus and coronary heart disease, Am J Med, 103, pp. 152-162, (1997)
[6] Reaven G.M., Insulin resistance and compensatory hyperinsulinemia: Role in hypertension, dyslipidemia, and coronary heart disease, Am Heart J, 121, pp. 1283-1288, (1991)
[7] Rett K., The relation between insulin resistance and cardiovascular complications of the insulin resistance syndrome, Diabetes Obes Metab, 1, 1 SUPPL., pp. 8-6, (1999)
[8] Festa A., D'agostino Jr. R., Howard G., Et al., Chronic subclinical inflammation as part of the insulin resistance syndrome: The insulin resistance atherosclerosis study (IRAS), Circulation, 102, pp. 42-47, (2000)
[9] Mokdad A.H., Serdula M., Dietz W.H., Et al., The spread of the obesity epidemic in the United States, 1991-1998, JAMA, 282, pp. 1519-1522, (1999)
[10] Must A., Spradano J., Coakley E.H., Et al., The disease burden associated with overweight and obesity, JAMA, 282, pp. 1523-1529, (1999)

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