What is the relationship between endothelial dysfunction, the insulin resistance syndrome, and vascular disease?
Endothelial dysfunction may be an intrinsic component of the insulin resistance syndrome, preceding type 2 diabetes and contributing to the high prevalence of vascular disease in these patients.
Abstract. Tooke JE, Hannemann MM (School of Postgraduate Medicine and Vascular Health Sciences, University of Exeter, Devon). Adverse endothelial function and the insulin resistance syndrome (Review). J Intern Med 2000; 247 : 425–431. Type 2 diabetes is characterized by impaired endothelial dependent vasodilatation which may contribute to the high prevalence of vascular disease in such patients. Although hyperglycaemia, dyslipidaemia and hypertension can all independently cause a similar defect, recent data suggest that endothelial dysfunction may be intrinsic to the insulin resistance syndrome that commonly precedes type 2 diabetes. Such abnormalities in endothelial function could represent the impact of subclinical disturbance of metabolism or alternatively the presence of a common cellular defect that influences both nitric oxide bioavailability and insulin mediated glucose disposal. Resolution of this puzzle is likely to lead to important advances in our knowledge and ultimately treatment of vascular disease.
Tooke et al. (Sat,) studied this question.