Insulineresistentie is de sterkste risicofactor voor hart- en vaatziekten

Insulin resistance is the strongest risk factor for cardiovascular disease

Apr 08, 2021Jasper Maalderink

At the beginning of this year, a Jama Cardiology magazine became a important study Published that demonstrated that insulin resistance is the strongest risk factor for cardiovascular disease. (Sagar B.Dugani, 2021)



This study followed 28,024 women during a period of 21.4 years.

During this time, 1,548 (5.5%) of the Women's HVZ developed.

The researcher collected data on more than 50 clinical factors and biomarkers, so that he could determine the strongest risk factors for heart disease. The risk associated with each variable was reported as a Hazards Ratio (HR), which is the multiple increase in the risk associated with the presence of that variable compared to when it is absent.

For example, if women with high triglycerides had twice as much opportunity on HVZ as women with lower triglycerides, the HR 2 would be.

Diabetes and insulin resistance

Diabetes from clinical studies was by far associated with the highest risk of HVZ. For women <55, Diabetes HR was 10.71. For women 55-65, Diabetes HR was 10.92.

In other words, having diabetes increased the risk of cardiovascular and vocals with more than 1000%!

It is not surprising that the metabolic syndrome (insulin resistance) had the second strongest association with HVZ.

Metabolic syndrome is defined by the presence of at least three of the following characteristics: low HDL, high triglycerides, high blood pressure, large belly circumference, high solid glucose or insulin.

I said "not surprisingly" because the metabolic syndrome is a disease that itself is associated with insulin resistance and diabetes. For women <55, the HR of metabolic syndrome was 6.09.

In accordance with the clinical studies, a blood marker of insulin resistance - lipoprotein insulin resistance (LIPR) - was the strongest risk factor under the biomarkers for HVZ.

The HR associated with LIPR was 6.4 in women <55. And the corresponding even remained existed when the researchers adapting for diabetes.

This data shows that if you want to reduce the risk of heart disease, you should focus on improving insulin resistance.

Probably the best way to do this is by following a clean carbohydrate diet.

Sleep and exercise as well as important lifestyle factors.



Nor surprising, was that HDL was negatively associated with HVZ and triglycerides were positively associated with HVZ.

Simply put, you want a high HDL and low triglycerides.

It is important that HDL and triglycerides were both stronger risk factors than LDL cholesterol, the so-called "bad cholesterol".

Here is a list of only a few clinical variables and markers associated with a greater risk of heart disease than LDL: overweight or obesity, smoking, diabetes, metabolic syndrome, high blood pressure, sedentary lifestyle, high triglycerides, low HDL and one of the four Markers of inflammation (CRP, fibrinogen, ICAM-1, glyca).

In fact, HR-associated LDL cholesterol was only 1.38, about 1/8 of the risk associated with diabetes.

In addition, when the researchers investigated the risk of the different LDL particle sizes, there was no connection between large downy LDL particles and HVZZ.

On the other hand, small LDL particles were associated with HVZ risk, HR = 2.25.

This is an extremely important detail, because when carbohydrate diets raise the LDL, they specifically do so by increasing the large LDL (Norwitz et al, 2020), while it often reduces the little LDL.

So even if the total LDL content rises in a carbohydrate diet, the risk may not be greater.

All this data show us that insulin resistance is a much stronger risk factor for heart disease than LDL.

In addition, statins, the most used drug to lower LDL cholesterol, can increase insulin resistance and the risk of diabetes.

Take a moment to allow it to penetrate ... and although a carbohydrate diet can increase the LDL, it tends to specifically raise the large LDL, which is not associated with an increased risk.

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