Insulin resistance: an independent risk factor for cardiovascular disease?

Summary Summary. Population‐based studies have shown that patients with type 2 diabetes have a higher cardiovascular morbidity and mortality and an increased all‐cause mortality compared with non‐diabetic subjects. In non‐diabetic subjects, hyperinsulinaemia not only has been associated with an increased cardiovascular risk, but is also related with a number of other cardiovascular risk factors – hyperglycaemia, hypertension, dyslipidaemia, and a central body fat distribution – that constitute the insulin resistance syndrome and are also characteristic of type 2 diabetes. After 23 years of follow‐up in the Paris Prospective Study, both fasting and 2‐h insulin concentrations were related with all‐cause mortality in a U‐shaped fashion, with low and high concentrations being associated with an increased risk, independently of other risk factors; in contrast, while high insulin levels carried an increased risk for cardiovascular and coronary heart disease mortality, this was not independent of other risk factors.