The insulin resistance syndrome.

Area of Science:

• Endocrinology and Metabolism
• Human Physiology
• Genetics

Background:

• Insulin resistance is a common metabolic abnormality characterized by reduced insulin-mediated glucose disposal.
• It can be primary (unknown origin, irreversible, organ/pathway-specific) or secondary.
• Primary insulin resistance affects approximately 25% of healthy individuals and is linked to non-insulin-dependent diabetes mellitus, hypertension, and dyslipidemia.

Purpose of the Study:

• To define and characterize primary insulin resistance.
• To explore the concept of an insulin resistance syndrome based on the clustering of related clinical conditions.
• To investigate the potential genetic and atherogenic components of this syndrome.

Main Methods:

• Review and synthesis of existing cross-sectional and longitudinal observations.
• Clinical characterization of primary insulin resistance.
• Conceptual framework development for the insulin resistance syndrome.

Main Results:

• Primary insulin resistance is a distinct entity, often linked to skeletal muscle glucose uptake defects.
• A significant overlap exists between primary insulin resistance and conditions such as non-insulin-dependent diabetes mellitus, essential hypertension, and dyslipidemia.
• These conditions tend to cluster, suggesting a common underlying pathophysiology.

Conclusions:

• The insulin resistance syndrome is proposed as a constellation of interrelated metabolic, anthropometric, and hemodynamic variables centered around insulin resistance or hyperinsulinemia.
• A significant genetic component likely contributes to the syndrome.
• The syndrome may predispose individuals to non-insulin-dependent diabetes mellitus, hypertension, dyslipidemia, and potentially, atherosclerosis.