High-Density Lipoprotein as a Key Component in the Prevention of Premature Atherosclerotic Disease in the Insulin Resistance Syndrome

The occurrence of insulin resistance syndrome (IRS), which is also called the metabolic syndrome, has rapidly increased over the last decade. IRS involves such major clinical features as premature atherosclerosis and its related complications. The major proatherogenic phenotype includes elevated plasma levels of apolipoprotein B-containing lipid particles. Another lipid particle of high-density lipoprotein (HDL) plays a key role in the prevention of atherosclerotic disease. Decreased levels of HDL cholesterol are found in IRS; however, little is known about metabolic pathways related to HDL antiatherogenic properties in this pathological condition. Hitherto, in other dyslipidemic populations, the antiatherogenic properties of HDL have been most frequently characterized in vitro. Recently, knowledge about antiatherogenic pathways in which HDL particles are involved in vivo has been accumulating. Consistent with these developments, new therapeutic strategies can be envisaged for IRS, including treatment with recombinant HDL particles and inhibitors of cholesteryl ester transfer protein.

KEYWORDS

Metabolic syndrome - insulin resistance - HDL - prevention - atherosclerotic disease

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