Insulin Resistance: the Link Between Obesity and Cardiovascular Disease
Insulin Resistance: the Link Between Obesity and Cardiovascular Disease
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DOI：
10.1016/j.mcna.2011.06.002
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发表时间：
2011-09-01
影响因子：
5.9
通讯作者：
Reaven, Gerald M.
中科院分区：
文献类型：
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作者：
Reaven, Gerald M.
胰岛素介导的葡萄糖处置在表面上健康的个体中至少变化了6倍。身体健康水平下降对胰岛素敏感性的不利影响与过度肥胖的不良影响相当，两者都约占胰岛素作用变异性的25%。正是胰岛素敏感性的丧失解释了为什么肥胖者更容易患上心血管疾病，但并不是所有超重/肥胖者都有胰岛素抵抗。在临床水平上，重要的是确定哪些超重的人也是胰岛素抵抗的，并在这一亚组中启动最密集的治疗努力。最后，通过身体质量指数估计的总体肥胖的不利影响似乎与通过腰围量化的腹型肥胖的负面影响相当。
Insulin-mediated glucose disposal varies at least sixfold in apparently healthy individuals. The adverse effect of decreases in the level of physical fitness on insulin sensitivity is comparable to the untoward impact of excess adiposity, with each accounting for approximately 25% of the variability of insulin action. It is the loss of insulin sensitivity that explains why obese individuals are more likely to develop cardiovascular disease, but not all overweight/obese individuals are insulin resistant. At a clinical level, it is important to identify those overweight individuals who are also insulin resistant and to initiate the most intensive therapeutic effort in this subgroup. Finally, it appears that the adverse impact of overall obesity, as estimated by body mass index, is comparable to that of abdominal obesity, as quantified by waist circumference.