Björntorp P
Department of Medicine I, Sahlgren's Hospital, University of Göteborg, Sweden.
Diabete Metab. 1987 Jul;13(3 Pt 2):381-5.
Hyperinsulinaemia is of great importance, being a primary risk factor for cardiovascular disease and non-insulin dependent diabetes (NIDDM). Furthermore, unwanted effects of increased exposure of tissues to insulin are known. Hyperinsulinaemia may, in principle, be caused by primary hypersecretion, or be a secondary consequence of diminished effectiveness of insulin in the periphery. Obesity is the commonest condition characterized by insulin resistance, which is seen most frequently when excess adipose tissue is localized to the abdominal region. Insulin resistance in obesity is found in several tissues, however, with liver and muscle being quantitative the most important. Muscle insulin sensitivity is regulated by genetic factors, hormonal effects, and the influence of free fatty acids, as well as the state of physical activity. There is evidence for the action of each of these factors in obesity. The pathogenetic mechanisms linking hyperinsulinaemia with cardiovascular disease and NIDDM are unknown. Comparisons between development of NIDDM in experimental animal models and in humans in prospective studies however, provide useful hypotheses for further studies.
高胰岛素血症非常重要，它是心血管疾病和非胰岛素依赖型糖尿病（NIDDM）的主要危险因素。此外，组织暴露于胰岛素增加所产生的不良影响也为人所知。原则上，高胰岛素血症可能由原发性高分泌引起，或者是外周胰岛素有效性降低的继发性后果。肥胖是最常见的以胰岛素抵抗为特征的病症，当过多的脂肪组织集中在腹部区域时最为常见。然而，肥胖中的胰岛素抵抗存在于多个组织中，其中肝脏和肌肉在数量上最为重要。肌肉胰岛素敏感性受遗传因素、激素作用、游离脂肪酸的影响以及身体活动状态的调节。有证据表明这些因素在肥胖中均有作用。高胰岛素血症与心血管疾病和NIDDM之间的发病机制尚不清楚。然而，在实验动物模型中NIDDM的发展与前瞻性研究中的人类进行比较，为进一步研究提供了有用的假设。
