THE SYNDROME OF INSULIN RESISTANCE

It is well known that excessive weight is associated with resistance t o insulin-mediated glucose uptake and predisposition to the developmen t of type II diabetes. It has been shown more recently that excessive weight and insulin resistance tend to be associated to android fat dis tribution, arterial hypertension, elevated levels of triglycerides, lo w concentration of HDL cholesterol and defective fibrinolysis. The ter ms syndrome of insulin resistance, metabolic syndrome or syndrome X ha ve been proposed to describe this cluster of abnormalities. The pathop hysiological mechanisms which could explain the interrelations between these different parameters are still only partly understood. Epidemio logical prospective studies have demonstrated that the metabolic syndr ome is a risk factor for coronary heart disease and type II diabetes. The mechanisms involved in the development of diabetes are relatively well established, but those which are implicated in the atherothrombot ic process are far from being cleary described. Anyway, sufficient pre sumption exists to attempt at decreasing insulin resistance when it ex ists. Physical training and, if indicated, weight reduction are the si mplest means.