[Insulin resistance].

Abstract

Peripheral insulin resistance with normal glucose homeostasis and compensatory hyperinsulinemia is a common feature of a series of conditions. It is usually present in obesity and initiates the events leading to non insulin dependent diabetes. It is also pathogenetically related to hypertension, dyslipidemias and clinical atherosclerosis, diseases that are frequently associated between them. Although its etiology remains partially unknown, strong evidences suggest that it is due to a post receptor defect, involving the intracellular signals that drive carbohydrate metabolism. This explains the preservation of other insulin actions and the effect of hyperinsulinemia on hypertension, dyslipidemia and atherogenesis. In obesity, the increased lipid oxidation and serum free fatty acid levels, inhibit enzymes and cofactors involved in carbohydrate metabolism. This leads to a reduction in glucose disposal and increases hepatic glucose output, outlining a post receptor defect leading to insulin resistance.