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(Circulation. 1996;93:1777-1779.)
© 1996 American Heart Association, Inc.

Articles

Insulin Resistance and Atherosclerosis

Common Roots for Two Common Diseases?

Heinrich Taegtmeyer, MD, DPhil

From the University of Texas-Houston Medical School, Department of Internal Medicine, Division of Cardiology.

Correspondence to Heinrich Taegtmeyer, MD, DPhil, Department of Internal Medicine, Division of Cardiology, University of Texas-Houston Medical School, 6431 Fannin, Suite 1.246, Houston, TX 77030. E-mail ht@heart.med.uth.tmc.edu.

Key Words: Editorials • atherosclerosis • diabetes mellitus • diagnosis • carotid arteries

	Introduction

 
Growing up in postwar Germany as I did taught me something that is hard to forget. When people had relatively little to eat, diseases such as NIDDM and atherosclerosis were almost unheard of. Today, these diseases occur in epidemic proportions. Furthermore, atherosclerosis is now the most common and deleterious complication of NIDDM. This issue of Circulation contains the first, long-awaited results of the Insulin Resistance Atherosclerosis Study, which examines the association between insulin sensitivity and IMT of the carotid artery as an index of atherosclerosis. The study is based on observations in three distinctly different ethnic groups of approximately equal size in four communities of the United States.¹ The results show an inverse relation between insulin sensitivity and atherosclerosis in Hispanic and non-Hispanic white Americans but not among black Americans. When the investigators adjusted their results for the traditional risk factors of coronary artery disease, glucose tolerance, measures of adiposity, and fasting insulin levels, this inverse relation was reduced but not eliminated. The powerful analysis suggests therefore that insulin resistance per se is an independent cause of atherosclerosis in non-Hispanic and Hispanic whites. It also suggests that the inverse relation between insulin sensitivity and atherosclerosis is stronger than the relation between insulin and atherosclerosis. The ethnic differences are not so readily explained, although it is of interest that non-Hispanic and Hispanic whites share the same characteristics.

The findings of the present study¹ provide support for the clinical observation that diabetes and macrovascular disease not only coexist but may spring from . . . [Full Text of this Article]

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