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I think the other thing where insulin, especially hyperinsulinemia, is playing a role is with endothelial dysfunction ... What is the cascade of events that leads to ASCVD? Endothelial dysfunction is an important risk factor. Why? Because if the endothelium is not working, the ApoB particles have an easier time getting through the gaps and into the sub-endothelial
space.
Peter Attia
Hyperinsulinemia Causes Endothelial Dysfunction, Increasing ASCVD Risk
AMA #43: Understanding apoB, LDL-C, Lp(a), and insulin as risk factors for cardiovascular disease
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