Insulin Resistance: the Metabolic Syndrome X (Contemporary by Gerald M. Reaven, Ami Laws

By Gerald M. Reaven, Ami Laws

Gerald Reaven, the discoverer of Syndrome X, and a panel of world-class investigators thoughtfully summarize our present realizing of ways insulin resistance and its compensating hyperinsulinemia play a massive position within the pathogenesis and scientific process hypertension and cardiovascular disease-the so-called ailments of Western civilization. those individual experts aspect, for the 1st time, the pathophysiological results and the scientific syndromes, aside from style 2 diabetes, regarding insulin resistance. additionally they research the genetic and way of life elements that give a contribution to the large variations in insulin motion that exist within the inhabitants at huge. well timed and authoritative, Insulin Resistance: The Metabolic Syndrome X illuminates the complete value of insulin resistance as a tremendous reason for high blood pressure, middle ailment, and polycystic ovary syndrome.

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SOUTH ASIANS Large-scale migration from South Asia to other countries has occurred during the last 160 years. The first report of high prevalence of diabetes in South Asian migrants was from Saigon in 1913 (3). Table 4 summarizes the results of recent surveys in South Asian populations that have used glucose tolerance tests and WHO criteria for the diagnosis of diabetes. The prevalence rates of about 20% in men and women aged over 35 years are remarkably consistent between overseas South Asian populations (4–9) and urban populations in South Asia itself (2,10,11).

86. Aitman TJ, Godsland IF, Farren B, Crook D, Wong HJ, Scott J. Defects of insulin action on fatty acid and carbohydrate metabolism in familial combined hyperlipidemia. Arterioscl Thromb Vasc Biol 1997;17:748–754. 87. Austin MA, King MC, Vranizan KM, Krauss RM. Atherogenic lipoprotein phenotype: a proposed genetic marker for coronary heart disease risk. Circulation 1990;82:495–506. 88. Phillips DIW, Caddy S, Ilic V, Fielding BA, Frayn KN, Borthwick AC, Taylor R. Intramuscular triglyceride and muscle insulin sensitivity: evidence for a relationship in nondiabetic subjects.

The size of the difference in predicted intimal-medial thickness at the 25th and 75th percentiles of insulin sensitivity was comparable to the size of effects associated with smoking or hypertension. Adjusting for glucose tolerance status did not fully account for the association in Whites. The lack of relation between carotid intimalmedial thickness and insulin sensitivity not in African-Americans (80) may reflect the lack of association between insulin resistance and hypertension in African-Americans, since hypertension is a main risk factor for atherosclerosis in the carotid arteries.

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