ABSTRACT
The resistance to insulin action is associated with impaired glucose tolerance, increased very low density lipoprotein triglyceride, decreased high density lipoprotein cholesterol, and hypertension. Resistance to the stimulatory effect of insulin on cellular glucose uptake will increase the serum concentration of endogenous insulin required to regulate blood glucose. The failure of insulin to exert its expected biological effect in vivo may be due to one or more potential mechanisms, including the production of abnormal beta cell secretory products, leading to a biologically defective insulin molecule. Insulin resistance may occur as a result of circulating insulin antagonists, including anti-insulin antibodies and anti-insulin receptor antibodies. Acanthosis nigricans is frequently associated with diabetes mellitus and insulin resistance with individuals showing antibodies directed against the insulin receptor. The association between obesity, abnormal lipid metabolism, and insulin resistance is reinforced by the improvement in insulin-stimulated glucose uptake and a reduction in plasma insulin and triglyceride levels by weight reduction in obese individuals.
