Why the study?
The pathological roles of insulin resistance in the development of diabetic heart disease are complex and not fully understood, and related therapeutic approaches remain underdeveloped.
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Design
Review
Targeting insulin resistance may benefit diabetes heart disease; leaves open confirmation in prospective trials.
Insulin resistance has been regarded as a hallmark of diabetes heart disease (DHD).Numerous studies have shown that insulin resistance can affect blood circulation and myocardium, which indirectly cause cardiac hypertrophy and ventricular remodeling, participating in the pathogenesis of DHD.Meanwhile, hyperinsulinemia, hyperglycemia, and hyperlipidemia associated with insulin resistance can directly impair the metabolism and function of the heart.Targeting insulin resistance is a potential therapeutic strategy for the prevention of DHD.Currently, the role of insulin resistance in the pathogenic development of DHD is still under active research, as the pathological roles involved are complex and not yet fully understood, and the related therapeutic approaches are not well developed.In this review, we describe insulin resistance and add recent advances in the major pathological and physiological changes and underlying mechanisms by which insulin resistance leads to myocardial remodeling and dysfunction in the diabetic heart, including exosomal dysfunction, ferroptosis, and epigenetic factors.In addition, we discuss potential therapeutic approaches to improve insulin resistance and accelerate the development of cardiovascular protection drugs.
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Lee et al. (2024) studied this question.
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