〈綜説〉インスリン抵抗性と代謝性症候群X(Metabolic Syndrome X)について

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Insulin resistance is a recognized characteristic of several disease states including obesity, noninsulin dependent diabetes(NIDDM), essential hypertension and atherosclerotic cardiovascular disease. In the Banting memorial lecture(1988)in New Oreans. Prof. Gerald Reaven(Stanford University)reviewed the role of insulin resistance in human disease and made the suggestion that there is a series of related variable(resistance to insulin-stimulated glucose uptake, hyper insulinemia, glucose intolerance, increased VLDL triglycerides, decreased HDL cholesterol and hypertension) that constitutes a syndrome, ¢syndrome　X£, and may be of importance in the genesis of coronary artery disease. He suggested that the common feature of the proposed syndrome is insulin resistance and that all other changes are likely to be secondary to this basic abnormality, At about the same time, Prof. Norman Kaplan(.University of Texas)also isolated what he called ¢The deadly quartet£ in which upper-body obesity has been added to hypertension, diabetes and hypertriglyceridemia to constitute a syndrome associated with an increased risk of cardiovascular disease. It is known that excessive body weight(especially visceral fat accumulation)is associated with insulin resistance and predisposition to the development of NIDDM, dyslipidemia and hypertension. The these mechanisms which could explain the interrelation between these different conditions are still only partly understood. In this documentation, the patophysiological mechanisms of these situations are reviwed from recent literatures.
九州大学の論文

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