A new study has revealed a surprising connection between insulin resistance and aortic stenosis (AS), the world’s most common heart valve disease.
This large population-based study, published in the journal Annals of Medicine, is the first to highlight insulin resistance as a potential risk factor for AS.
Aortic stenosis is a serious heart condition where the aortic valve narrows, making it harder for blood to flow out of the heart. Over time, the valve becomes stiff and thick, forcing the heart to work harder.
If left untreated, AS can lead to heart failure and other life-threatening complications. People with this condition may experience symptoms such as chest pain, fatigue, shortness of breath, or heart palpitations. However, many people may not show any symptoms for years.
Previously known risk factors for AS include older age, being male, high blood pressure, smoking, and diabetes. But now, researchers believe that insulin resistance could also play a role in the development of the disease.
Insulin resistance happens when the body’s cells stop responding properly to insulin, the hormone that helps control blood sugar levels. To make up for this, the body produces more insulin, leading to higher insulin levels in the blood—a condition known as hyperinsulinemia. Insulin resistance is also a key early feature of type 2 diabetes.
In this new study, researchers examined data from 10,144 Finnish men between the ages of 45 and 73. None of them had aortic stenosis at the beginning of the study. The participants were part of a long-term project called the Metabolic Syndrome in Men (METSIM) Study. Over an average follow-up of nearly 11 years, 116 men (1.1%) developed AS.
The scientists looked at several indicators related to insulin resistance, including fasting insulin, insulin levels after 30 and 120 minutes, proinsulin, and serum C-peptide levels.
They found that higher levels of these biomarkers were linked to an increased risk of developing AS. Importantly, these results held true even after adjusting for other risk factors like age, blood pressure, and body weight. The findings also remained valid when people with diabetes or a malformed aortic valve were excluded from the analysis.
To better understand the link, the team used advanced statistical methods to identify two specific patterns of insulin resistance that predicted AS risk. This suggests that insulin resistance may be an independent risk factor for AS, separate from other known risks like obesity and high blood pressure.
“This is a new and important finding,” said lead author Dr. Johanna Kuusisto from Kuopio University Hospital in Finland. “Because insulin resistance is common in Western countries, improving metabolic health may offer a new strategy to reduce the risk of developing aortic stenosis, especially in older adults.”
The study’s strengths include its large number of participants and long-term follow-up. However, the researchers noted that the study only included men, and the number of people who developed AS was relatively small.
These factors may limit how well the findings apply to other populations, such as women or people from different ethnic backgrounds.
Still, the results open the door to new ways of preventing AS. Future studies will need to explore whether improving insulin sensitivity—through lifestyle changes like diet, exercise, and weight control—can reduce the risk of this serious heart condition.
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The study is published in Annals of Medicine.
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