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Insulin Resistance Predicts A Diversity Of Age-Related Diseases

In the final post, I reviewed a report past times Gerald Reaven's grouping showing that insulin resistance strongly predicts the lead chances of cardiovascular illness over a 5-year period.  In 2001, Reaven's grouping published an fifty-fifty to a greater extent than hitting follow-up outcome from the same cohort (1).  This report shows that non exclusively does insulin resistance predict cardiovascular illness risk, it too predicts a multifariousness of age-related diseases, including hypertension, coronary pump disease, stroke, cancer, type 2 diabetes, together with fifty-fifty overall mortality risk.


The study

The report was real like to the previous one: first, they recruited 147 thin together with overweight middle-aged volunteers without diabetes or diagnosed cardiovascular disease.  Then, they measured the volunteers' insulin sensitivity.  While most studies of this nature indirectly guess insulin sensitivity merely past times using a formula based on fasting insulin together with glucose measurements (HOMA-IR), which tin move inaccurate, Reaven's grouping direct measured insulin sensitivity using a aureate measure method*.

Next, they waited vi years together with watched who developed a multifariousness of diseases over that period.

The results

As inwards the previous study, they divided the volunteers into 3 equal-sized groups based on their flat of insulin resistance. Group I had the lowest flat of insulin resistance, grouping II had an intermediate level, together with grouping III had the highest level.  The next graph illustrates the issue of people who were diagnosed alongside illness (and/or died) inwards each grouping over the course of report of the study:


As y'all tin see, over the 6-year period, none of the people inwards the to the lowest degree insulin-resistant grouping developed illness or died.  In contrast, 36 percent of the people inwards the most insulin-resistant grouping developed illness and/or died, from a multifariousness of causes including hypertension, coronary pump disease, stroke, type 2 diabetes, together with cancer.  People inwards the middle grouping had an intermediate charge per unit of measurement of disease.

This is an incredibly hitting result.

Again, people who were most insulin-sensitive too had a multifariousness of other salubrious signs, including less trunk fatness, higher physical activity, lower blood pressure, lower levels of LDL ("bad") cholesterol, together with the higher levels of HDL ("good") cholesterol.  And again, afterwards mathematically adjusting for all of these other factors, "only insulin resistance was an independent predictor of the twoscore age-related clinical events."

Discussion

Many researchers, including myself, believe that insulin resistance is a key characteristic of a metabolic dysfunction syndrome that drives much of the chronic illness of the modern affluent world.  Reaven's results strongly back upward this contention, since they demo that insulin resistance clusters non exclusively alongside a multifariousness of other metabolic disturbances, but too alongside the lead chances of a multifariousness of mutual chronic diseases.

These results don't permit us to know whether insulin resistance caused the other metabolic disturbances and/or diseases, rather than merely beingness associated alongside them, but other query gives us practiced argue to suspect that it does play at to the lowest degree somewhat of a causal role.  Insulin resistance is intimately involved inwards the evolution of type 2 diabetes, which is itself damaging to the cardiovascular system.  Insulin resistance too contributes to disturbed blood lipid levels, including elevated LDL particle issue together with reduced HDL-cholesterol, which farther harm cardiovascular health.  The human relationship of insulin resistance alongside cancer is less straightforward, but the elevated insulin levels that accompany insulin resistance are idea to drive the progression of sure as shooting cancers.  Also, insulin resistance is typically associated alongside chronic, low-grade inflammation, some other constituent that tin promote the evolution of cancer.

Even though insulin resistance together with elevated insulin levels don't reliably predict weight gain over fourth dimension (2, 3), insulin resistance does predict chronic illness risk.  This suggests that fifty-fifty though insulin resistance likely doesn't play a major role inwards trunk fatness, it's even together with thence a metabolic characteristic nosotros should help quite a flake about.


* Insulin suppression test, which is a direct mensurate of insulin sensitivity that is highly correlated alongside euglycemic-hyperinsulinemic clamp (4).  The output is "SSPG" or Steady-State Plasma Glucose, which is the flat of blood glucose that results from "clamping" circulating insulin at a standardized level.  The higher your blood glucose (SSPG) is at a given flat of circulating insulin, the to a greater extent than insulin-resistant y'all are.
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