| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
School of Medicine, Stanford University, Stanford, California 94305
The ability of insulin to stimulate glucose disposal varies more than six-fold in apparently healthy individuals. The one third of the population that is most insulin resistant is at greatly increased risk to develop cardiovascular disease (CVD), type 2 diabetes, hypertension, stroke, nonalcoholic fatty liver disease, polycystic ovary disease, and certain forms of cancer. Between 25–35% of the variability in insulin action is related to being overweight. The importance of the adverse effects of excess adiposity is apparent in light of the evidence that more than half of the adult population in the United States is classified as being overweight/obese, as defined by a body mass index greater than 25.0 kg/m2. The current epidemic of overweight/obesity is most-likely related to a combination of increased caloric intake and decreased energy expenditure. In either instance, the fact that CVD risk is increased as individuals gain weight emphasizes the gravity of the health care dilemma posed by the explosive increase in the prevalence of overweight/obesity in the population at large. Given the enormity of the problem, it is necessary to differentiate between the CVD risk related to obesity per se, as distinct from the fact that the prevalence of insulin resistance and compensatory hyperinsulinemia are increased in overweight/obese individuals. Although the majority of individuals in the general population that can be considered insulin resistant are also overweight/obese, not all overweight/obese persons are insulin resistant. Furthermore, the cluster of abnormalities associated with insulin resistance - namely, glucose intolerance, hyperinsulinemia, dyslipidemia, and elevated plasma C-reactive protein concentrations — is limited to the subset of overweight/obese individuals that are also insulin resistant. Of greater clinical relevance is the fact that significant improvement in these metabolic abnormalities following weight loss is seen only in the subset of overweight/obese individuals that are also insulin resistant. In view of the large number of overweight/obese subjects at potential risk to be insulin resistant/hyperinsulinemic (and at increased CVD risk), and the difficulty in achieving weight loss, it seems essential to identify those overweight/obese individuals who are also insulin resistant and will benefit the most from weight loss, then target this population for the most-intensive efforts to bring about weight loss.
This article has been cited by other articles:
 |
|
 |
|
  C. Zoccali The obesity epidemics in ESRD: from wasting to waist? Nephrol. Dial. Transplant., October 24, 2008; (2008) gfn589v1. [Full Text] [PDF]
|
|
|
|
 |
|
 M. R. Martins, A. K. G. Vieira, E. P. G. de Souza, and A. S. Moura Early overnutrition impairs insulin signaling in the heart of adult Swiss mice J. Endocrinol., September 1, 2008; 198(3): 591 - 598. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J.-P. Despres, I. Lemieux, J. Bergeron, P. Pibarot, P. Mathieu, E. Larose, J. Rodes-Cabau, O. F. Bertrand, and P. Poirier Abdominal Obesity and the Metabolic Syndrome: Contribution to Global Cardiometabolic Risk Arterioscler. Thromb. Vasc. Biol., June 1, 2008; 28(6): 1039 - 1049. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M.-Y. Wang, P. Grayburn, S. Chen, M. Ravazzola, L. Orci, and R. H. Unger Adipogenic capacity and the susceptibility to type 2 diabetes and metabolic syndrome PNAS, April 22, 2008; 105(16): 6139 - 6144. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 N. Mody, T. E. Graham, Y. Tsuji, Q. Yang, and B. B. Kahn Decreased clearance of serum retinol-binding protein and elevated levels of transthyretin in insulin-resistant ob/ob mice Am J Physiol Endocrinol Metab, April 1, 2008; 294(4): E785 - E793. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. MacLaren, W. Cui, S. Simard, and K. Cianflone Influence of obesity and insulin sensitivity on insulin signaling genes in human omental and subcutaneous adipose tissue J. Lipid Res., February 1, 2008; 49(2): 308 - 323. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Lee, R. Muniyappa, X. Yan, H. Chen, L. Q. Yue, E.-G. Hong, J. K. Kim, and M. J. Quon Comparison between surrogate indexes of insulin sensitivity and resistance and hyperinsulinemic euglycemic clamp estimates in mice Am J Physiol Endocrinol Metab, February 1, 2008; 294(2): E261 - E270. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 I. Hers Insulin-like growth factor-1 potentiates platelet activation via the IRS/PI3K{alpha} pathway Blood, December 15, 2007; 110(13): 4243 - 4252. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K. E. Innes and H. K. Vincent The Influence of Yoga-Based Programs on Risk Profiles in Adults with Type 2 Diabetes Mellitus: A Systematic Review Evid. Based Complement. Altern. Med., December 1, 2007; 4(4): 469 - 486. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. Cournil, R. Defay, A. Lacroux, S. Barny, A. Fontbonne, and for the CALDIA Study Group Paradoxical Relationships Between Anthropometric Variables and Phenotypic Expression of the Metabolic Syndrome in Nondiabetic Polynesians of New Caledonia Diabetes Care, July 1, 2007; 30(7): 1909 - 1911. [Full Text] [PDF]
|
|
|
|
 |
|
 M. A. Rettenbacher, M. Hummer, A. Hofer, S. Baumgartner, C. Ebenbichler, M. EdLinger, G. Kemmler, M. Lechleitner, and W. Wolfgang Fleischhacker Alterations of glucose metabolism during treatment with clozapine or amisulpride: results from a prospective 16-week study J Psychopharmacol, June 1, 2007; 21(4): 400 - 404. [Abstract] [PDF]
|
|
|
|
 |
|
 H. Sampath, M. Miyazaki, A. Dobrzyn, and J. M. Ntambi Stearoyl-CoA Desaturase-1 Mediates the Pro-lipogenic Effects of Dietary Saturated Fat J. Biol. Chem., January 26, 2007; 282(4): 2483 - 2493. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. M. van den Hoek, A. C. Heijboer, P. J. Voshol, L. M. Havekes, J. A. Romijn, E. P. M. Corssmit, and H. Pijl Chronic PYY3-36 treatment promotes fat oxidation and ameliorates insulin resistance in C57BL6 mice Am J Physiol Endocrinol Metab, January 1, 2007; 292(1): E238 - E245. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. Li, X. Kong, E. Owsley, E. Ellis, S. Strom, and J. Y. L. Chiang Insulin Regulation of Cholesterol 7{alpha}-Hydroxylase Expression in Human Hepatocytes: ROLES OF FORKHEAD BOX O1 AND STEROL REGULATORY ELEMENT-BINDING PROTEIN 1c J. Biol. Chem., September 29, 2006; 281(39): 28745 - 28754. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C.-H. Kim, P. Pennisi, H. Zhao, S. Yakar, J. B. Kaufman, K. Iganaki, J. Shiloach, P. E. Scherer, M. J. Quon, and D. LeRoith MKR mice are resistant to the metabolic actions of both insulin and adiponectin: discordance between insulin resistance and adiponectin responsiveness Am J Physiol Endocrinol Metab, August 1, 2006; 291(2): E298 - E305. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. D. Jensen Adipose tissue as an endocrine organ: implications of its distribution on free fatty acid metabolism Eur. Heart J. Suppl., May 1, 2006; 8(suppl_B): B13 - B19. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
V. Vartanian, B. Lowell, I. G. Minko, T. G. Wood, J. D. Ceci, S. George, S. W. Ballinger, C. L. Corless, A. K. McCullough, and R. S. Lloyd The metabolic syndrome resulting from a knockout of the NEIL1 DNA glycosylase PNAS, February 7, 2006; 103(6): 1864 - 1869. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E. J. Brunner, M. J. Shipley, D. R. Witte, J. H. Fuller, and M. G. Marmot Relation Between Blood Glucose and Coronary Mortality Over 33 Years in the Whitehall Study Diabetes Care, January 1, 2006; 29(1): 26 - 31. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 G. Reaven Insulin Resistance, Type 2 Diabetes Mellitus, and Cardiovascular Disease: The End of the Beginning Circulation, November 15, 2005; 112(20): 3030 - 3032. [Full Text] [PDF]
|
|
|
|
 |
|
 K. E. Innes, C. Bourguignon, and A. G. Taylor Risk Indices Associated with the Insulin Resistance Syndrome, Cardiovascular Disease, and Possible Protection with Yoga: A Systematic Review J Am Board Fam Med, November 1, 2005; 18(6): 491 - 519. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Lafontan, C. Moro, C. Sengenes, J. Galitzky, F. Crampes, and M. Berlan An Unsuspected Metabolic Role for Atrial Natriuretic Peptides: The Control of Lipolysis, Lipid Mobilization, and Systemic Nonesterified Fatty Acids Levels in Humans Arterioscler. Thromb. Vasc. Biol., October 1, 2005; 25(10): 2032 - 2042. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. M. Paterson, J. R. Seckl, and J. J. Mullins Genetic manipulation of 11{beta}-hydroxysteroid dehydrogenases in mice Am J Physiol Regulatory Integrative Comp Physiol, September 1, 2005; 289(3): R642 - R652. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 H. Chen, G. Sullivan, and M. J. Quon Assessing the Predictive Accuracy of QUICKI as a Surrogate Index for Insulin Sensitivity Using a Calibration Model Diabetes, July 1, 2005; 54(7): 1914 - 1925. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Zvonic, J. C. Hogan, P. Arbour-Reily, R. L. Mynatt, and J. M. Stephens Effects of Cardiotrophin on Adipocytes J. Biol. Chem., November 12, 2004; 279(46): 47572 - 47579. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
W.-D. Li, C. Dong, D. Li, C. Garrigan, and R. A. Price A Quantitative Trait Locus Influencing Fasting Plasma Glucose in Chromosome Region 18q22-23 Diabetes, September 1, 2004; 53(9): 2487 - 2491. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 B. J. Goldstein and R. Scalia Adiponectin: A Novel Adipokine Linking Adipocytes and Vascular Function J. Clin. Endocrinol. Metab., June 1, 2004; 89(6): 2563 - 2568. [Abstract] [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
| Endocrinology | Endocrine Reviews | J. Clin. End. & Metab. |
| Molecular Endocrinology | Recent Prog. Horm. Res. | All Endocrine Journals |
