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 Presentation

"Insulin Resistance and Cardiovascular Disease - Pleiotropic Effects of Glitazones"

Dr. Subodh Verma (biography)
English - 2005-11-08 - 70 minutes
(51 slides)
(35 slides)

Summary :
Insulin resistance is associated with increased cardiovascular risk even after adjusting for traditional and non-traditional risk factors (1), and in 2002 the American Heart Association stated that “Treating insulin resistance early should be part of a global cardiovascular and metabolic strategy.”

The syndrome of insulin resistance includes at least 20 different abnormalities which seem to cluster together and these include type 2 diabetes, endothelial dysfunction, inflammation, hypercoagulability, dyslipidemia and hypertension to name a few.

In the last few years, insulin sensitising PPARγ agonists such as rosiglitazone and pioglitazone have been found to have certain pleiotropic vascular benefits. These include for example effects to reduce vascular inflammation, improve endothelial function, modulate the bone-marrow response to atherosclerosis, stabilize vulnerable plaques, improve fibrinolysis, improve cardiac function and reduce adipokines.

Here Dr. Verma gives an in-depth review of animal and clinical data illustrating the known pleiotropic effects of glitazones and how they may impact on atherosclerosis progression.

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Learning objectives :
After viewing this presentation the participant will be able to discuss:

- Evidence for the link between insulin resistance and CVD risk
- Direct and indirect pathways through which PPARγ can affect atherosclerosis
- Experimental and clinical evidence for pleiotropic vascular benefits of glitazones
- Ongoing outcome studies with glitazones

Bibliographic references :
1. Anthony J.G. Hanley, PhD, Ken Williams, MSc, Michael P. Stern, MD and Steven M. Haffner, MDHomeostasis Model Assessment of Insulin Resistance in Relation to the Incidence of Cardiovascular Disease: The San Antonio Heart StudyDiabetes Care 25:1177-1184, 2002.

   


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