The deadly quartet and the insulin resistance syndrome: an historical overview

Since the original observations by Vague almost 50 years ago, a massive literature has documented the pathological consequences of upper body or visceral obesity. These consequences likely relate to the presence of hyperinsulinemia. More recently, the presence of hyperinsulinemia has also been recognized in nonobese hypertensives as a feature of the insulin resistance syndrome. This paper will provide an historical overview of the two clinical syndromes.