Metabolic Syndrome
Insulin resistance syndrome
Syndrome X
Insulin resistance, the associated hyperinsulinemia and hyperglycemia, and adipocyte cytokines (adipokines) may also lead to vascular endothelial dysfunction, an abnormal lipid profile, hypertension, and vascular inflammation, all of which promote the development of atherosclerotic cardiovascular disease (CVD) [1-4].
For adipokines, refer to pathogenesis of DM2:
Adipokines, factors released from adipocytes, stimulate inflammatory activity which correlates with insulin resistance .
The incidence of type 2 diabetes has been correlated with increased levels of markers of inflammation, including C reactive protein, IL-6, plasminogen activator inhibitor-1 (PAI-1), and white cell count .
1-Adiponectin: An adipocyte-derived cytokine,
reduces levels of blood free fatty acids
and has been associated with improved lipid profiles,
better glycemic control,
and reduced inflammation in diabetic patients.
2-Tumor necrosis factor-alpha:
Studies in genetically obese animals suggest that increased release of TNF-alpha (TNFa) from adipocytes may play a major role in the impairment in insulin action .
The applicability of these findings to humans is uncertain.
Some studies found a strong correlation between the degree of obesity, hyperinsulinemia, and TNFa mRNA in adipose tissue.
3- Plasminogen activator inhibitor 1, an inhibitor of fibrinolysis, is another protein related to adipocytes.
4- Resitin:
In diet-induced or genetic obesity in mice, adipocytes secrete a signaling molecule named resistin. Administration of resistin decreases while neutralization of resistin increases insulin-mediated glucose uptake by adipocytes
Thus, resistin may be a hormone that links obesity to diabetes.
5- Retinol-binding protein 4 (RBP4), another protein released from adipocytes.