Insulin Resistance and Lipid Disorders

Roberto Miccoli; Cristina Bianchi; Giuseppe Penno; Stefano Del Prato

Disclosures

Future Lipidology. 2008;3(6):651-664. 

In This Article

Future Perspective

Excessive caloric intake, poorly balanced diet with relative increase in saturated fat, low physical activity and subsequent increase in the prevalence of obesity seem to be the most distinct features of civilization. As a result, the risk of T2DM and its complication, as well as cardiovascular disease, is becoming a major burden in our societies. Insulin resistance may play an important role in favoring the clustering of multiple cardiovascular risk factors in a given individual. It is certain that insulin resistance and the accompanying hyperinsulinemia can directly affect lipid metabolism at the level of several tissues (adipose tissue, muscle, liver, pancreatic β-cell etc.) as well as lipoprotein metabolism, leading to the development of atherogenic dyslipidemia. The understanding of the complex mechanism underlying these defects may represent the best opportunity for appropriate and rationale therapeutic approach. Thus, understanding these interactions may allow identification of individuals most likely to respond to specific dietary interventions, but also to design medication that may have a better safety:efficacy ratio. In the near future, it is expected that a better understanding will develop on the gene-environment relationship. In the meantime, a more comprehensive appreciation of reciprocal effects of insulin resistance and atherogenic dyslipidemia should guide the physician in a more conscious therapeutic decision.

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