1. In Metabolic Syndrome Hyperinsulinism Creates the Vicious Cycle: Increased MAP-kinase pathway
Circulation. 2005;111: Metabolic Syndrome A Comprehensive Perspective Based on Interactions Between Obesity,
Diabetes, and InflammationParesh Dandona

2. Peripheral Insulin Resistance- Induced or Genetically-Induced Hyperinsulinemia has Adverse Downstream Effects
Hyperinsulinemia
Insulin
Metabolic pathway
(PI3K)
Mitogenic pathway
(MAPK)
Insulin-
Resistance
Hyperglycemia
Proliferation, ENDOTHELIAL DYSFUCTION, INFLAMMATION
ASVD
Glucose transport
Glykogen synthese
Obesity leads to Insulin resistance by
Phosphorylating IRS-1

3. Vascular Effects of Function of NO vs Endothelin
Vascular actions of insulin with implications for endothelial dysfunction
Maria Assunta PotenzaAm J Physiol Endocrinol Metab 297: E568–E577, 2009.

4. IR and Vasculature-
Nitricoxide and mitochondria in metabolic syndrome Larisa Litvinova, Frontiers in Physiology, February2015|Volume6|Article20 | 1

5. Coronary Blood Flow Decreased and Coronary Vascular Resistance Increased with Increased Weight
markers of
metabolic
syndrome
such as BMI,
HDL chol.,
insulin
resistance,
and CRP
plasma
level were
predictive
of the
alterations
in MBF

6. Abnormalities seen with IR/ Compensatory Hyperinsulinemia:
Risk Factors for ASVD