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The profile of a typical heart disease patient has shifted over the past 30 years from the hypertensive, chain-smoking, type A personality to someone with overweight or obesity and concomitant diabetes

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He W, Wang X, Zhan D, Li M, Wang Q, Liu J, et al

Large-scale association analyses identify new loci influencing glycemic traits and provide insight into the underlying biological pathways

In addition, hyperinsulinemia dysregulates the mTORC1 signaling pathway, lowering muscle protein synthesis and activating the ubiquitin-proteasome system, ultimately enhancing protein degradation (59, 60)