Division of Cardiovascular Medicine, Stanford University School of Medicine, Falk CVRC Stanford Medical Center, 300 Pasteur Dr, Stanford, CA 94306, USA.
Arterioscler Thromb Vasc Biol. 2012 Aug;32(8):1754-9. doi: 10.1161/ATVBAHA.111.241885.
The goal of this review was to summarize evidence supporting the view that insulin resistance/compensatory hyperinsulinemia play an important role in the pathogenesis of coronary heart disease (CHD) in nondiabetic individuals. Results of case-control and epidemiological studies in nondiabetic individuals will be reviewed to examine the link between insulin resistance/compensatory hyperinsulinemia, associated abnormalities, and CHD. The primary focus of the review will be on the central role that dyslipidemia plays in the link between insulin resistance/compensatory hyperinsulinemia and CHD. Additional issues to be addressed include the following: (1) the relationship among obesity, insulin resistance, and CHD; (2) a listing of other abnormalities that contribute to risk of CHD in insulin-resistant individuals; and (3) discussion of the importance of differential tissue insulin sensitivity in the development of abnormalities that increase CHD risk in insulin-resistant, nondiabetic individuals. The information will reflect the author's decision as to what issues are believed to be of particular relevance or less well appreciated concerning the complex relationship between insulin resistance and CHD. Resistance to insulin-mediated glucose disposal and hyperinsulinemia is a common finding in apparently healthy individuals and is associated with a number of abnormalities that greatly increase risk of CHD.
本综述的目的是总结支持胰岛素抵抗/代偿性高胰岛素血症在非糖尿病个体冠心病（CHD）发病机制中起重要作用的证据。将回顾非糖尿病个体的病例对照和流行病学研究结果，以检验胰岛素抵抗/代偿性高胰岛素血症、相关异常与 CHD 之间的联系。本综述的重点将是脂质异常在胰岛素抵抗/代偿性高胰岛素血症与 CHD 之间的联系中所起的核心作用。需要解决的其他问题包括：（1）肥胖、胰岛素抵抗和 CHD 之间的关系；（2）有助于胰岛素抵抗个体 CHD 风险的其他异常的列举；（3）讨论组织胰岛素敏感性的差异在胰岛素抵抗的非糖尿病个体中增加 CHD 风险的异常发展中的重要性。这些信息将反映作者的决定，即哪些问题被认为与胰岛素抵抗和 CHD 之间复杂关系有关，或者被认为不太为人所知。胰岛素介导的葡萄糖摄取抵抗和高胰岛素血症是表型健康个体的常见现象，与许多极大增加 CHD 风险的异常有关。
