Insulin Resistance (cont.)
What medical conditions are associated with insulin resistance?
While the metabolic syndrome links insulin resistance
with abdominal obesity, elevated cholesterol and high blood pressure, there are several medical other conditions that are associated
with insulin resistance specifically. It may be that insulin resistance is the cause of some of these
conditions, but this has not yet been proven. Conditions associated with insulin
resistance
include:
Type 2 Diabetes
Overt
diabetes may be the first sign that insulin resistance is present. While it can
be noted long before diabetes develops, in cases where there is reluctance or
inability to see a physician regularly,
insulin resistance can present as type 2 diabetes.
Fatty liver
Fatty liver is
strongly associated with insulin resistance. The accumulation of fat in the
liver is a manifestation of the disordered control of lipids that occurs with
insulin resistance. Fatty liver associated with insulin resistance may be mild
or severe. Newer evidence suggests that fatty liver may even lead to
cirrhosis
of the liver and, possibly, liver cancer.
Arteriosclerosis
Arteriosclerosis, also known as atherosclerosis, is a process of progressive
thickening and hardening of the walls of medium-sized and large arteries.
Arteriosclerosis is responsible for:
Other
risk factors for arteriosclerosis include:
- high levels of "bad" (LDL) cholesterol,
- high blood
pressure,
- smoking,
- diabetes, and a
- family history of
arteriosclerosis.
Skin Lesion
Skin lesions include increased skin tags and a condition called acanthosis
nigricans - a darkening and thickening of the skin especially in fold areas such
as the neckline and axilla. This condition is directly related to the insulin
resistance, though the exact mechanism is not known.
- Acanthosis
nigricans: Acanthosis nigricans is a cosmetic
condition strongly associated with insulin resistance in which there is
darkening of the skin in areas where there are creases such as the neck and arm
pits.
- Skin tags: Skin tags are
also seen with increased frequency in patients with insulin resistance. A skin
tag is a common, benign condition which consists of a bit of skin that projects
from the surrounding skin and may appear attached to the skin. Skin tags can
vary quite a bit in appearance. They may be smooth or irregular, flesh colored
or more deeply pigmented, and either simply be raised above the surrounding skin
or have a stalk (a peduncle) so that the skin tag hangs from the skin.
Reproductive abnormalities in
women
Reproductive abnormalities include difficulty with ovulation and
conception (infertility),
irregular menses, or a cessation of menses. In contrast, there are no known reproductive abnormalities in men with
insulin resistance.
Polycystic ovary disease
Polycystic ovary disease is
a hormonal problem that affects young women. It is associated with irregular
periods or no periods at all, obesity, and increased growth of body hair.
Hyperandrogenism
High male
hormone levels, which are produced by the ovaries can been seen in insulin resistance and
may play a role in PCOS described above. Why this association occurs is not
known, but it's thought that the insulin resistance somehow causes the abnormal
ovarian hormone production.
Growth abnormalities
There
may be growth affects in insulin resistance due to the high levels of
circulating insulin that may be present. While insulin's effects on glucose
metabolism may be impaired, it's effects on other mechanisms may be intact (or
at least less impaired). Insulin is an anabolic and can exert effects on growth,
through a medicator known as insulin- like growth factor -1. Patients may have
actual linear growth and a noticeable coarsening of features. The increase
incidence of skin tags mentioned
above may be through this mechanism as well.
Next: Who is at risk for insulin resistance? »
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