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Insulin resistance is associated with an increased risk of aortic stenosis
Last reviewed: 03.07.2025
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A new large population-based study published in the Annals of Medicine has found a link between insulin resistance and an increased risk of developing aortic stenosis (AS) in men over age 45. This is the first study to point to insulin resistance as a previously unrecognized risk factor for this disease.
Aortic stenosis and its consequences
Aortic stenosis is a common heart valve disorder that causes the aortic valve to narrow, making it difficult for blood to flow out of the heart. Over time, the valve thickens and becomes less flexible, forcing the heart to work harder. If left untreated, it can lead to serious complications such as heart failure.
What is insulin resistance?
Insulin resistance occurs when the body's cells stop responding effectively to insulin, causing the pancreas to produce more of the hormone to maintain normal blood glucose levels. This condition precedes the development of type 2 diabetes and is associated with hyperinsulinemia (high levels of insulin in the blood).
Key findings of the study
The study included 10,144 men aged 45 to 73 years who were participating in the Metabolic Syndrome in Men (METSIM) program. Participants did not have aortic stenosis at study entry. Over a mean follow-up of 10.8 years, 116 men (1.1%) were diagnosed with AS.
The researchers identified several biomarkers associated with insulin resistance that were significant predictors of AS, including:
- Fasting insulin level;
- Insulin 30 and 120 minutes after exercise;
- Proinsulin;
- C-peptide.
These biomarkers remained significant even after accounting for other risk factors such as body mass index (BMI), blood pressure and diabetes.
Meaning of the results
The study authors used advanced statistical methods to identify two patterns of biomarkers that point to insulin resistance as an independent risk factor for AS.
"Insulin resistance is a significant and modifiable risk factor. Metabolic health management, such as weight control and physical activity, may help reduce the risk of aortic stenosis," said Dr. Johanna Kuusisto, lead author of the study.
Limitations and Prospects
The study had several limitations, including a focus on men and a relatively small number of AS cases. Further studies that include women and other populations are needed to confirm the findings.
This finding highlights the importance of metabolic health for the prevention of cardiovascular disease, particularly in aging Western populations.