Nearly a half century ago, the Framingham Study identified cigarette smoking, high blood pressure, elevated serum cholesterol, and advancing age as risk factors for coronary heart disease (CHD).1 Unfortunately, knowledge about these risk factors, either alone or in combination, does not predict most new cases of CHD. This has led to investigation of other presumed risk factors including diabetes mellitus,2 obesity,3 physical inactivity,4 and such psychosocial variables as type A behavior pattern5 and hostility.6. The association between diabetes mellitus and atherosclerosis in several epidemiological studies7-9 focused attention on the possible role of insulin as a mediating variable. Subsequent prospective studies have linked elevated insulin concentration in the blood of nondiabetic individuals to an increased incidence of myocardial infarction and CHD. Although the exact manner by which insulin metabolism is related to atherosclerosis is not understood, its known relationships to diabetes mellitus, obesity, and physical inactivity make it a prime candidate for study. The focus of this report is on how insulin metabolism may be an important variable linking health behaviors and lipid metabolism.
ASJC Scopus subject areas
- Endocrinology, Diabetes and Metabolism