Insulin and endothelial function: A brief review

Background: In recent years, the novel effects of insulin beyond control of glucose metabolism have been appreciated, especially those that impact vascular function. A better understanding of insulin's protective interactions with the endothelium has provided clinicians with a justification for more aggressive use of insulin—not only to control glucose levels, but also to potentially reduce the progression of atherosclerosis and its pathogenic sequelae.

Objective: In this brief review, we provide a snapshot of the available research and clinical findings signifying beneficial effects of insulin on the endothelium.

Methods: We conducted a MEDLINE search of articles published in English from 1965 through 2007 using the search terms insulin, endothelium, and anti-inflammatory. Articles with a focus on “insulin resistance” per se were excluded from this review.

Results: The literature search identified 200 articles that addressed the effects of insulin on endothelium and the interaction between insulin and the vasculature.

Conclusions: In addition to mitigating hyperglycemic toxicity, insulin has multiple beneficial interactions with the endothelium in physiologic and disease states. The anti-inflammatory actions of insulin confer beneficial effects in preventing and minimizing morbidity and mortality due to atherosclerosis, especially in acute settings like myocardial infarction.