ABSTRACT: Chronic metabolic and cardiovascular diseases, described as the epidemics of XXI century, are connected to the resistance of peripheral tissues, such as liver, muscle and fat, to insulin. Insulin resistance, which precedes the development of type 2 diabetes by several years, is difficult to diagnose, mainly because of practical limitations to the use of "gold standard" hyperinsulinemic euglycemic clamp technique for screening. It is also begins a certain vicious circle, in which insulin resistant peripheral tissues force pancreatic beta cells to increased insulin release, and sustained high concentrations of insulin cause further development of insulin resistance. Currently, there are two major hypotheses describing the mechanism of insulin resistance: one relating to the "lipid overload" in liver and muscle cells as the key factor and another one emphasizing the role of lipid accumulation in adipocytes, which leads to the overgrowth of fatty tissue and chronic local inflammation.
Postepy biochemii 01/2011; 57(2):200-6.