Insulin and Endothelial Function: A Brief Review

Intekhab Ahmed, MD, and Barry J. Goldstein, MD, PhD

Since its discovery, insulin has maintained a key position for its principal effects on glucose metabolism. Within the past several decades, we have witnessed a major surge in our ability to decipher insulin's actions beyond glucose metabolism. One of the key effects of insulin in the vasculature has been its interaction with the endothelium; epidemiologic evidence indicates a potential link between insulin and cardiovascular morbidity and mortality. The prevailing dogma holds that insulin and the endothelium maintain a delicate relationship that is essential for normal functioning of the organ lining the blood vessels of the body. Dysfunction of the endothelium is observed in insulin-resistant states, including obesity, glucose intolerance, and type 2 diabetes mellitus.