Summary

In conditions with insulin resistance, it is well established that systemic abnormalities, such as dyslipidemia and hypertension, can effect cells in the vascular wall and cause atherosclerosis. Emerging research suggests that insulin resistance within vascular endothelial cells can lead directly to atherosclerosis independently of systemic factors. This effect is large and may be a major determinant of atherosclerosis in metabolic syndrome or type 2 diabetes.