Insulin Resistant Syndromes in Humans
Clinical states of insulin resistance are characterized by elevated circulating levels of insulin and resistance to the action of exogenous insulin (Berson and Yalow, 1970). In some states of insulin resistance, delivery of insulin to target tissues is impaired; however, in most, the delivery of insulin to its peripheral target tissues is normal and the resistance results from peripheral antagonism to the action of insulin. Several recent studies have examined the interaction of insulin with its target cell receptors in clinical conditions of diminished sensitivity to insulin (Bar and Roth, 1977; Kahn, Megyesi, Bar, Eastman, and Flier, 1977). These studies have demonstrated that both the concentration and the affinity of the insulin receptors undergo wide fluctuation under numerous biologically relevant conditions. Several conditions were characterized by decreases in the concentration of receptors, with the decrease in receptor concentration related to the severity of the insulin resistance. In other conditions, changes in receptor affinity were predominant and were unrelated to the environmental insulin concentration. Taken together, these studies indicate that the insulin receptor is a major site for the regulation of target cell responsiveness in vivo.
KeywordsInsulin Resistance Obese Patient Insulin Receptor Plasma Insulin Level Insulin Binding
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