Kosmas Constantine E, Silverio Delia, Tsomidou Christiana, Salcedo Maria D, Montan Peter D, Guzman Eliscer
Division of Cardiology, Department of Medicine, Mount Sinai Hospital, New York, NY, USA.
Cardiology Clinic, Cardiology Unlimited PC, New York, NY, USA.
Clin Med Insights Endocrinol Diabetes. 2018 Aug 1;11:1179551418792257. doi: 10.1177/1179551418792257. eCollection 2018.
There is extensive evidence showing that insulin resistance (IR) is associated with chronic low-grade inflammation. Furthermore, IR has been shown to increase the risk for cardiovascular disease (CVD), even in nondiabetic patients, and is currently considered as a "nontraditional" risk factor contributing to CVD by promoting hypertension, oxidative stress, endothelial dysfunction, dyslipidemia, and type 2 diabetes mellitus. However, chronic kidney disease (CKD) is also considered a state of low-grade inflammation. In addition, CKD is considered an IR state and has been described as an independent risk factor for the development of CVD, as even early-stage CKD is associated with an estimated 40% to 100% increase in CVD risk. There is also strong evidence indicating that inflammation per se plays a crucial role in both the initiation and progression of CVD. Given the above, the combined effect of IR and CKD may significantly increase the risk of inflammation and CVD. This review aims to focus on the complex interplay between IR, CKD, inflammation, and CVD and will present and discuss the current clinical and scientific data pertaining to the impact of IR and CKD on inflammation and CVD.
有大量证据表明胰岛素抵抗（IR）与慢性低度炎症相关。此外，IR已被证明会增加心血管疾病（CVD）的风险，即使在非糖尿病患者中也是如此，目前它被视为通过促进高血压、氧化应激、内皮功能障碍、血脂异常和2型糖尿病而导致CVD的“非传统”风险因素。然而，慢性肾脏病（CKD）也被认为是一种低度炎症状态。此外，CKD被视为一种IR状态，并被描述为CVD发生发展的独立风险因素，因为即使是早期CKD也与CVD风险估计增加40%至100%相关。也有强有力的证据表明炎症本身在CVD的发生和发展中都起着关键作用。鉴于上述情况，IR和CKD的联合作用可能会显著增加炎症和CVD的风险。本综述旨在聚焦于IR、CKD、炎症和CVD之间复杂的相互作用，并将呈现和讨论当前有关IR和CKD对炎症和CVD影响的临床和科学数据。
