Are Hypertriglyceridemia and Low HDL Causal Factors in the Development of Insulin Resistance?

Insulin resistance often occurs with dyslipidemia as part of the metabolic syndrome and the current dominant paradigm is that insulin resistance leads to dyslipidemia. However, dyslipidemia may also cause insulin resistance; this was postulated 30 years ago, but has never been substantiated. Establishing whether dyslipidemia plays a causal role in the etiology of insulin resistance is important since it could reveal new avenues for combating type 2 diabetes. In this review we summarize recent evidence from epidemiological, genetic and intervention studies to re-address this old hypothesis.