Lipid therapy for cardiovascular disease with insulin resistance, diabetes, or the metabolic syndrome.

Insulin resistance with the development of diabetes or metabolic syndrome is associated with characteristic lipid abnormalities and an increased likelihood of cardiovascular events. This review examines the rationale and clinical trial evidence for the benefit of lipid drug therapy in the presence of these related high-risk conditions. In particular, the results of the more recent statin trials are discussed and contrasted with evidence from trials with fibrates, which, although fewer in number, appear to show that this particular therapy has selective benefit for the overweight individual with diabetes or features of the metabolic syndrome.