Impairment of glucose tolerance: mechanism of action and impact on the cardiovascular system

American Journal of Obstetrics and Gynecology
H Beck-NielsenJ E Henriksen

Abstract

Macrovascular disease, especially coronary heart diseases, have been found to be linked to glucose intolerance. Insulin resistance in respect to glucose uptake in peripheral tissues seems to play an important role in the development of glucose intolerance, since subjects with coronary heart disease mainly are hyperinsulinemic. Insulin resistance may induce not only glucose intolerance but also hypertension, obesity, and dyslipoproteinemia (high very low-density lipoprotein and low high-density lipoprotein values), all variables that add to the risk of coronary heart disease. On the basis of these findings, a new syndrome has been postulated-syndrome X. This syndrome may be caused by inherited insulin resistance in skeletal muscles, and secondary to that arterial hypertension, obesity, and dyslipoproteinemia may develop. Insulin resistance in noninsulin-dependent diabetic persons and in hypertensive subjects is located in skeletal muscles, where insulin's ability to promote nonoxidative glucose metabolism is reduced. The key enzyme in this pathway, glycogen synthase, is proposed as the causal defect responsible for the insulin resistance state, at least in noninsulin-dependent diabetic patients. The pill (sex steroids) may induc...Continue Reading

Citations

Dec 1, 1992·The Journal of Adolescent Health : Official Publication of the Society for Adolescent Medicine·J D KeyL Everett
Aug 1, 1995·Diabetic Medicine : a Journal of the British Diabetic Association·M S DjurhuusH Beck-Nielsen
Mar 1, 1993·American Journal of Obstetrics and Gynecology·D Shoupe

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