Nearly 40 years ago, experiments 11 showed that infusion of insulin into one femoral artery of a dog resulted in atherosclerotic changes in the artery. The mechanism through which insulin resistance influences atherogenesis, however, is unclear. A recent study implicates thrombotic factors. 12 Obesity Many persons with one or more of the conditions listed above are obese. Obesity is a component of the syndrome, but it promotes insulin resistance rather than resulting from it.
Weight loss can improve insulin sensitivity and reduce insulin levels.
Higher plasminogen activator inhibitor 1 levels and decreased low-density lipoprotein particle diameter are thought to increase the risk of coronary heart disease. 13 Diagnosis Diagnosis of each of the diseases that comprise insulin resistance syndrome is usually straightforward and familiar. By the time a diagnosis of hypertension or diabetes is made, however, complications are often already present. Furthermore, insulin resistance and hyperinsulinemia often have been present for years, conferring an increased risk for the development of other components of the syndrome, including coronary heart disease. The precise way in which insulin resistance develops is unclear, although genetics, diet and level of physical activity are believed to play a role.