Samaras Katherine, McElduff Aidan, Twigg Stephen M, Proietto Joseph, Prins John B, Welborn Timothy A, Zimmet Paul, Chisholm Donald J, Campbell Lesley V
Diabetes and Obesity Program, Garvan Institute of Medical Research, Sydney, New South Wales.
Med J Aust. 2006 Aug 7;185(3):159-61. doi: 10.5694/j.1326-5377.2006.tb00506.x.
Insulin resistance is considered a core component in the pathophysiology of the metabolic syndrome. Some clinicians measure serum insulin concentrations in the mistaken belief that they can be used to diagnose insulin resistance. Serum insulin levels are poor measures of insulin resistance. Furthermore, there is no clinical benefit in measuring insulin resistance in clinical practice. Measurements of fasting serum insulin levels should be reserved for large population-based epidemiological studies, where they can provide valuable data on the relationship of insulin sensitivity to risk factors for diabetes and cardiovascular disease. Clinicians should shift from identifying "insulin resistance" to identifying risk factors, such as fasting glucose and lipid levels, hypertension and central obesity. These proven risk factors converge within the metabolic syndrome. Individuals "at risk" of diabetes and atherosclerotic cardiac disease can be identified simply and inexpensively, using classic clinical techniques, such as history-taking, physical examination, and very basic investigations.
胰岛素抵抗被认为是代谢综合征病理生理学的核心组成部分。一些临床医生测量血清胰岛素浓度，错误地认为可以用其诊断胰岛素抵抗。血清胰岛素水平并非衡量胰岛素抵抗的良好指标。此外，在临床实践中测量胰岛素抵抗并无临床益处。空腹血清胰岛素水平的测量应保留用于大规模人群流行病学研究，在这类研究中，其可为胰岛素敏感性与糖尿病和心血管疾病危险因素之间的关系提供有价值的数据。临床医生应从识别“胰岛素抵抗”转向识别危险因素，如空腹血糖和血脂水平、高血压和中心性肥胖。这些已被证实的危险因素在代谢综合征中相互关联。通过病史采集、体格检查和非常基础的检查等经典临床技术，能够简单且低成本地识别出糖尿病和动脉粥样硬化性心脏病的“高危”个体。
