A major new study suggests that insulin resistance, a common condition that often develops years before type 2 diabetes, may increase the risk of a serious heart valve disease called aortic stenosis.
The research, carried out in Finland, followed more than 10,000 men for over a decade and is believed to be the first large study to show a clear link between insulin resistance and this common heart condition. The findings were published in the journal Annals of Medicine.
Aortic stenosis is the most common heart valve disease worldwide. It develops when the aortic valve, which controls blood flow from the heart to the rest of the body, gradually becomes thicker, harder, and narrower.
As the opening becomes smaller, the heart must work much harder to push blood through the valve. Over time, this extra strain can weaken the heart and eventually lead to heart failure, irregular heartbeats, or even death if the condition is not treated.
Many people do not notice symptoms during the early stages of aortic stenosis because the disease develops slowly over many years. As the narrowing becomes more severe, symptoms such as chest pain, tiredness, shortness of breath, dizziness, fainting, and a rapid heartbeat may appear.
Once symptoms develop, treatment is often needed, and many patients eventually require surgery or a procedure to replace the damaged valve.
Doctors already know that getting older is the biggest risk factor for aortic stenosis. Men, people with high blood pressure, smokers, and those with diabetes also have a higher chance of developing the disease.
However, scientists are still trying to understand why some people develop aortic stenosis while others do not. Discovering new risk factors could lead to better ways to prevent the disease before permanent valve damage occurs.
The new study focused on insulin resistance. Insulin is a hormone that helps move sugar from the blood into the body’s cells, where it is used for energy. In people with insulin resistance, the cells stop responding normally to insulin.
To compensate, the pancreas produces larger amounts of insulin to keep blood sugar under control. This causes unusually high insulin levels in the blood, known as hyperinsulinemia. Insulin resistance often develops many years before type 2 diabetes is diagnosed and is closely linked with excess body weight, lack of physical activity, and metabolic syndrome.
Researchers from Kuopio University Hospital examined information collected through the Metabolic Syndrome in Men, or METSIM, Study. The study included more than 10,000 Finnish men between the ages of 45 and 73 who did not have aortic stenosis when the research began.
The participants were followed for an average of about 11 years. During this time, 116 men were diagnosed with aortic stenosis.
At the beginning of the study, the researchers measured several blood markers that reflect insulin resistance. These included fasting insulin levels, insulin levels measured 30 minutes and 120 minutes after glucose testing, proinsulin, and C-peptide. These markers provide a detailed picture of how hard the body is working to control blood sugar.
The researchers found that men with higher levels of these markers were more likely to develop aortic stenosis during the follow-up period. Importantly, the association remained even after taking into account other well-known risk factors such as age, body weight, blood pressure, and diabetes.
This suggests that insulin resistance itself may contribute to the development of the disease rather than simply reflecting other health problems.
To strengthen their conclusions, the team used advanced statistical methods to test the results in different ways. They identified two separate patterns showing that insulin resistance was independently linked with aortic stenosis. The findings remained consistent after adjusting for obesity, diabetes, and other cardiovascular risk factors.
Lead author Dr. Johanna Kuusisto said the findings are important because insulin resistance is very common in many countries. If future studies confirm these results, improving metabolic health could become a new strategy for reducing the risk of aortic stenosis as people age.
Lifestyle measures such as maintaining a healthy weight, exercising regularly, and improving diet are already known to improve insulin sensitivity and reduce the risk of type 2 diabetes and heart disease. Researchers now want to know whether these same approaches might also help protect the heart valves.
The researchers note that the study has several strengths, including its large number of participants, careful blood testing, and long follow-up period. However, there are also limitations.
The study included only men, so it is not yet known whether the same relationship exists in women. In addition, only 116 participants developed aortic stenosis, so further studies involving larger and more diverse populations are needed.
Overall, the research provides new evidence that insulin resistance may play a previously unrecognized role in the development of aortic stenosis. While more research is needed before doctors can recommend new prevention strategies, the findings highlight another reason why maintaining good metabolic health is important.
Preventing insulin resistance may not only reduce the risk of diabetes but could also help protect the heart and its valves later in life.
If you care about heart health, please read studies about how eating eggs can help reduce heart disease risk, and herbal supplements could harm your heart rhythm.
For more health information, please see recent studies about how drinking milk affects risks of heart disease and cancer, and results showing strawberries could help prevent Alzheimer’s disease.
The study was published in Annals of Medicine.
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