Bkaily Ghassan, Jazzar Ashley, Abou-Aichi Amira, Jacques Danielle
Department of Immunology and Cell Biology, Faculty of Medicine and Health Sciences, University of Sherbrooke, Sherbrooke, QC J1H 5N4, Canada.
Biomedicines. 2025 Jul 29;13(8):1842. doi: 10.3390/biomedicines13081842.
Hyperinsulinemia refers to an elevated level of circulating insulin (80 and 100 µU/mL), often leading to metabolic disorders such as obesity, insulin resistance, and type 2 diabetes (T2D). There is no precise and universally accepted definition of hyperinsulinemia and insulin resistance. The literature in the field remains unclear regarding whether insulin resistance precedes the development of hyperinsulinemia. Recently, a new hypothesis has been proposed suggesting that chronic hyperinsulinemia precedes and causes insulin resistance. The causes of the initiation of hyperinsulinemia, insulin resistance, and type 2 diabetes are multifactorial. Thus, it is not easy to define in general. Recent work demonstrates that the main prediabetic factor leading to insulin resistance is chronic hyperinsulinemia. However, recent work in the literature proposes that relatively long-term hyperinsulinemia does precede insulin resistance and already promotes cardiovascular remodeling. This later may lead to the development of vascular diseases such as hypertension. Thus, defining hyperinsulinemia and insulin resistance, as well as their signaling pathways implicated in the development of type 2 diabetes (T2D), needs to be clarified.
高胰岛素血症是指循环胰岛素水平升高（80至100微单位/毫升），常导致肥胖、胰岛素抵抗和2型糖尿病（T2D）等代谢紊乱。目前尚无关于高胰岛素血症和胰岛素抵抗的确切且被普遍接受的定义。该领域的文献对于胰岛素抵抗是否先于高胰岛素血症的发生仍不明确。最近，有人提出了一种新假说，认为慢性高胰岛素血症先于并导致胰岛素抵抗。高胰岛素血症、胰岛素抵抗和2型糖尿病起始的原因是多因素的。因此，总体上很难定义。近期研究表明，导致胰岛素抵抗的主要糖尿病前期因素是慢性高胰岛素血症。然而，文献中的近期研究提出，相对长期的高胰岛素血症确实先于胰岛素抵抗，并已促进心血管重塑。这随后可能导致高血压等血管疾病的发生。因此，需要阐明高胰岛素血症和胰岛素抵抗，以及它们在2型糖尿病（T2D）发生过程中涉及的信号通路。
