Adverse endothelial function and the insulin resistance syndrome

Type 2 diabetes is characterized by impaired endothelial dependent vasodila tation which may contribute to the high prevalence of vascular disease in s uch patients. Although hyperglycaemia, dyslipidaemia and hypertension can a ll independently cause a similar defect, recent data suggest that endotheli al dysfunction may be intrinsic to the insulin resistance syndrome that com monly precedes type 2 diabetes. Such abnormalities in endothelial function could represent the impact of subclinical disturbance of metabolism or alte rnatively the presence of a common cellular defect that influences both nit ric oxide bioavailability and insulin mediated glucose disposal. Resolution of this puzzle is likely to lead to important advances in our knowledge an d ultimately treatment of vascular disease.