Association of syndromes of insulin resistance with coronary artery disease.

Insulin resistance and its associated conditions, type 2 diabetes mellitus and the metabolic syndrome, have assumed great public health significance in relation to the development of atherosclerotic coronary artery disease. While the overall incidence of coronary artery disease has been declining, its incidence has been increasing in populations with insulin resistance. When insulin resistance is present in conjunction with type 2 diabetes mellitus and/or the metabolic syndrome, as well as other risk factors, the chance of developing coronary artery disease is strikingly increased as are the frequency and severity of its complications. In these situations, insulin resistance may behave synergistically with other risk factors. In addition to clustering with conventional risk factors, more recent evidence indicates that insulin resistance is linked with 'non-traditional' coronary artery disease risk factors and possibly with a pro-atherosclerotic inflammatory state.