In people with insulin（胰岛素） resistance or full-blown diabetes¹（糖尿病） , an inability to keep blood sugar levels under control isn't the only problem by far. A new report in the May issue of Cell Metabolism²（新陈代谢） , a Cell Press publication, shows that our arteries³（动脉） suffer the effects of insulin resistance, too, just for entirely⁴ different reasons. "We think about insulin resistance in liver, muscle, and fat, but insulin also works on vascular⁵（血管的） cells," said Christian⁶ Rask-Madsen of the Joslin Diabetes Center in Boston.

And what insulin does in our arteries sends a signal that helps prevent the buildup of fatty plaques⁸（版块，瓷片） that can cause arteries to harden, new research in mice shows.

Earlier studies showed that in the context of systemic insulin resistance, blood vessels⁹ become resistant¹⁰, too. Doctors also knew that insulin resistance and the high insulin levels to which it leads are independent risk factors for vascular disease（血管疾病） . But it wasn't clear if arteries become diseased because they can't respond to insulin or because they get exposed to too much of it.

Now comes evidence in favor of（赞同，支持） the former explanation. Rask-Madsen along with George King and their colleagues find that mice prone¹¹ to atherosclerosis（动脉硬化） fare much worse when the linings¹²（衬里，内里） of their arteries can't respond to insulin. The animals' insulin-resistant arteries develop plaques that are twice the size of those on normal arteries.

Insulin-resistant blood vessels don't open up as well, and levels of a protein known as VCAM-1 go up in them, too.

VCAM-1 belongs to a family of adhesion（支持，粘附） molecules¹³, Rask-Madsen explained. "It sits on the endothelium（内皮） and binds¹⁴ white blood cells." Those cells can enter the artery¹⁵ wall, where they start taking up cholesterol¹⁶（胆固醇） , and an early plaque⁷ is born.

"The results provide definitive¹⁷ evidence that loss of insulin signaling in the endothelium, in the absence of competing systemic risk factors, accelerates atherosclerosis," the researchers conclude.

The findings should come as good news to those on insulin therapy, since they suggest the hormone¹⁸ itself should not cause harm to arteries, as some had feared. "If anything, it should be beneficial in preventing atherosclerosis（动脉硬化） ," Rask-Madsen said.

The results also suggest drugs specifically designed to treat insulin resistance in the vasculature（脉管系统） might prevent cardiovascular complications in people with insulin resistance or type 2 diabetes, the researchers say.

While the researchers emphasize that it will remain critical to keep blood sugar in check with more traditional therapies, new treatments aimed at blood vessels could mean big gains for those with diabetes. After all, atherosclerosis is responsible for many of diabetes' worst complications—heart disease, stroke, and leg amputations（截肢，切断） among them.

"Atherosclerosis is the main reason for shorter life spans（寿命，使用期限） in diabetes patients," Rask-Madsen said.