Review article

Metabolic Insulin Resistance and Metabolism of Fats

Diana Muačević-Katanec

Abstract

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.

Keywords

metabolic insulin resistance; VLDL; LDL; HDL; tryglicerides; pharmacotherapy

Hrčak ID:

19000

URI

https://hrcak.srce.hr/19000

Publication date:

15.11.2004.

Article data in other languages: croatian

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