Background: Obese insulin-resistance is one of the most important risk factor
for cardiovascular diseases including ischemic heart disease (IHD). Growing evidences
suggest that the susceptibility to myocardial ischemia-reperfusion (I/R) injury is increased
in an obese insulin-resistance condition. Based on the currently available evidence from
human and animal studies, this review mainly focuses on the influence of obese insulinresistance
on the outcome of the I/R insult to the heart. Moreover, we have discussed
whether improving insulin sensitivity by pharmacological interventions could ameliorate
reperfusion induced myocardial injury.
Methods: The electronic database Pubmed was used as the source of selected peerreviewed
research articles published in English. Both pre-clinical studies and clinical trials
were obtained using obesity, insulin resistance, ischemia-reperfusion injury and myocardial
infarction as keywords.
Results: Twenty-seven pre-clinical studies were obtained using obesity, insulin resistance,
and cardiac ischemia-reperfusion injury as keywords, and five clinical trials were
obtained using obesity, insulin resistance, and myocardial infarction as keywords. The
underlying mechanisms responsible for the exacerbation of I/R injury in obese insulinresistance
were the main subject of our review.
Conclusion: The findings of this review suggest that the susceptibility to I/R injury is increased
in an obese insulin-resistance condition. However, the underlying mechanisms responsible
for the exacerbation of I/R injury in obese insulin-resistance have not been fully
elucidated, but increased basal oxidative stress, the impairment of anti-oxidant capacities,
insulin signaling and pro-survival signaling and increased inflammation, likely play an