Pregledni rad
Metabolic Insulin Resistance and Metabolism of Fats
Diana Muačević-Katanec
Sažetak
Dyslipidaemia in metabolic insulin resistance
is an important risk factor in the development
of atherosclerosis. A number of studies have shown
a signifi cant relationship between plasma insulin and
triglyceride concentrations, and defi ned a direct relationship
between resistance to insulin-mediated glucose disposal,
compensatory hyperinsulinemia and hepatic secretion of
very low density lipoprotein triglycerides (VLDL-TG). When
dyslipidaemia is not adequately controlled in subjects with
metabolic insulin resistance by lifestyle interventions,
pharmacologic approaches are warranted. Statins are fi rstline
pharmacotherapy due to their effi cacy for lowering
low-density lipoprotein levels, and may also improve highdensity
lipoprotein cholesterol (HDL) and triglyceride (TG)
levels. Fibrates can be used as monotherapy for lowering
triglycerides or raising HDL cholesterol. Fibrates and/
or nicotinic acid may be useful in combination with a
statin for additionally lowering triglycerides or raising HDL
cholesterol. Niacin is the most effective pharmacotherapy
currently available for raising HDL cholesterol levels. It has
benefi cial effects on other components of the atherogenic
lipid triad, including lowering triglyceride levels, increasing
LDL particle size, and reducing the concentration of small
LDL particles.
Ključne riječi
metabolic insulin resistance; VLDL; LDL; HDL; tryglicerides; pharmacotherapy
Hrčak ID:
19000
URI
Datum izdavanja:
15.11.2004.
Posjeta: 4.291 *