Скачать или смотреть EXPLORING THE COMPLEX RELATIONSHIP BETWEEN INSULIN , LIPID METABOLISM, AND CARDIOVASCULAR RISK

The focus of this review is to explore the complex relationship between insulin resistance, lipid metabolism, and cardiovascular risk. Cardiovascular disease (CVD) is a predominant concern for individuals with diabetes mellitus, serving as a leading cause of illness and death worldwide. Individuals with diabetes face a substantially higher risk of CVD compared to those without the condition, highlighting the need for comprehensive management. This analysis evaluates strategies to reduce cardiovascular risk in diabetic individuals and synthesizes evidence-based preventative measures and treatment choices, offering insights for healthcare practitioners and researchers.

The link between diabetes and severe cardiovascular complications is driven by several interconnected mechanisms. Insulin resistance is a central factor connecting diabetes to CVD, contributing directly to dyslipidemia and atherogenesis and thereby increasing the likelihood of cardiovascular events. Atherogenic dyslipidemia is characterized by elevated triglycerides, reduced HDL-C levels, and the formation of small, dense LDL-C particles that are especially atherogenic. In addition, hyperglycemia-induced oxidative stress and inflammation promote endothelial dysfunction, leading to vascular injury. This interplay accelerates atherosclerotic plaque development and increases plaque vulnerability, raising the risk of myocardial infarction and stroke.

To mitigate these risks, the review discusses a variety of preventive and therapeutic interventions. Lifestyle modifications, including regular physical activity and adherence to dietary patterns such as the DASH or Mediterranean diets, are essential for improving insulin sensitivity and lipid profiles. Pharmacological therapy includes the use of statins and newer lipid-lowering agents such as PCSK9 inhibitors, which substantially reduce LDL-C levels and cardiovascular events. Certain antidiabetic medications, particularly Sodium-Glucose Cotransporter-2 (SGLT-2) inhibitors (such as Empagliflozin and Canagliflozin) and Glucagon-Like Peptide-1 (GLP-1) receptor agonists (such as Liraglutide), provide notable cardiovascular benefits by improving metabolic parameters and reducing major cardiovascular events.

Comprehensive care also involves strict blood pressure control, often targeting levels below 130 mmHg, using medications such as ACE inhibitors and ARBs. Smoking cessation remains a critical measure in reducing macrovascular complications.

Ultimately, understanding the multifaceted connection between diabetes and cardiovascular disease is crucial for designing effective interventions. The review emphasizes the importance of a multidisciplinary care model—engaging cardiologists, endocrinologists, primary care physicians, and other specialists—to create individualized treatment plans. When combined with patient education, empowerment, and the integration of digital health technologies, this unified approach has the potential to enhance outcomes, improve quality of life, and reduce mortality among individuals managing both diabetes and cardiovascular disease.