Insulin Resistance and Cardiometabolic Health

Insulin resistance, a diminished cellular response to insulin, lies at the heart of cardiometabolic dysfunction and underpins the development of type 2 diabetes, metabolic syndrome and a spectrum of cardiovascular diseases. When insulin signalling is impaired, glucose uptake by muscle and adipose tissue falls, hepatic glucose production rises and lipid metabolism becomes dysregulated, fostering dyslipidaemia, hypertension and pro-inflammatory states. This clustering of risk factors accelerates atherosclerotic change, endothelial dysfunction and microvascular injury, with global consequences for morbidity and mortality. Research has expanded our understanding of how genetic predisposition interacts with environmental drivers—excess caloric intake, sedentary lifestyle and psychosocial stress—to shape individual trajectories of cardiometabolic risk. Contemporary approaches seek to identify simple, reliable surrogate markers of insulin sensitivity for population screening, refine mechanistic insights at the molecular level and develop targeted interventions—ranging from diet and exercise regimens to pharmacotherapies with pleiotropic metabolic and vascular benefits. A cohesive strategy that integrates early risk stratification, precision lifestyle modification and novel therapeutic agents holds promise for curbing the worldwide burden of insulin resistance-related cardiovascular disease.

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Insulin Resistance and Cardiometabolic Health publication trend

The graph below shows the total number of articles in insulin resistance and cardiometabolic health across all publications each year (not limited to Nature Index journals).

Technical terms

Insulin resistance: A state in which cells fail to respond adequately to normal circulating levels of insulin, leading to impaired glucose uptake and metabolic dysregulation.

Estimated glucose disposal rate (eGDR): A surrogate index of insulin sensitivity calculated from clinical parameters (such as waist circumference, hypertension status and HbA1c) that correlates with gold-standard clamp measures.

Triglyceride–glucose index (TyG index): A composite marker derived from fasting triglyceride and glucose values used to estimate insulin resistance in epidemiological studies.

Homeostasis model assessment of insulin resistance (HOMA-IR): A method for quantifying insulin resistance based on fasting insulin and glucose concentrations, widely used in research settings.

Endothelial dysfunction: Impaired regulation of vascular tone and barrier function by the endothelium, often resulting from metabolic and inflammatory insults and contributing to atherogenesis.

References

1. Insulin resistance assessed by estimated glucose disposal rate and risk of incident cardiovascular diseases among individuals without diabetes: findings from a nationwide, population based, prospective cohort study. Cardiovascular Diabetology (2024).
2. Estimated glucose disposal rate and risk of cardiovascular disease: evidence from the China Health and Retirement Longitudinal Study. BMC Geriatrics (2022).
3. Positive association of triglyceride-glucose index with new-onset hypertension among adults: a national cohort study in China. Cardiovascular Diabetology (2023).