Role of insulin resistance in human disease (syndrome X): an expanded definition

Annu Rev Med. 1993;44:121-31. doi: 10.1146/annurev.me.44.020193.001005.

Abstract

Resistance to insulin-mediated glucose uptake is characteristic of individuals with impaired glucose intolerance or non-insulin-dependent diabetes, and it also occurs commonly in patients with high blood pressure. The physiological response to a decrease in insulin-mediated glucose uptake is an increase in insulin secretion, and as long as a state of compensatory hyperinsulinemia can be maintained, frank decompensation of glucose tolerance can be prevented. However, it is likely that the defect in insulin action and/or the associated hyperinsulinemia will lead to an increase in plasma triglyceride and a decrease in high density lipoprotein-cholesterol concentration, and high blood pressure. It seems likely that the cluster of changes associated with resistance to insulin-mediated glucose uptake comprise a syndrome, which plays an important role in the etiology and clinical course of patients with non-insulin-dependent diabetes, high blood pressure, and coronary heart disease.

Publication types

  • Review

MeSH terms

  • Diabetes Mellitus, Type 2 / physiopathology
  • Humans
  • Hyperinsulinism / physiopathology
  • Hyperlipidemias / physiopathology
  • Hypertension / physiopathology
  • Insulin Resistance / physiology*
  • Syndrome