Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2008 Jul;31(7):1433-8.
doi: 10.2337/dc08-0045.

Insulin resistance and hyperinsulinemia: you can't have one without the other

Sun H Kim  1 , Gerald M Reaven
Affiliations

Insulin resistance and hyperinsulinemia: you can't have one without the other

Sun H Kim et al. Diabetes Care. 2008 Jul.

Abstract

Objective: Recently, it has been suggested that insulin resistance and hyperinsulinemia can exist in isolation and have differential impacts on cardiovascular disease (CVD). To evaluate this suggestion, we assessed the degree of discordance between insulin sensitivity and insulin response in a healthy, nondiabetic population.

Research design and methods: Insulin sensitivity was quantified by determining the steady-state plasma glucose (SSPG) concentration during an insulin suppression test in 446 individuals. The integrated insulin response was calculated after a 75-g oral glucose challenge. We analyzed the correlation between insulin resistance and insulin response in addition to quantifying the proportion in quartiles of insulin response by quartiles of insulin sensitivity. Then we compared CVD risk factors between individuals within the same insulin sensitivity quartile but within different insulin response quartiles to evaluate the differential clinical impact of insulin resistance and hyperinsulinemia.

Results: Insulin resistance and insulin response were highly correlated (r = 0.76, P < 0.001). A majority (95%) of the most insulin-resistant individuals (top SSPG quartile) were either in the highest insulin response quartile (71%) or second highest (24%). Similarly, 92% of the most insulin-sensitive individuals (lowest SSPG quartile) were in the lowest two insulin response quartiles. There were minimal differences in CVD risk factors between individuals with different insulin responses but within the same insulin sensitivity quartile.

Conclusions: Although not perfectly related, insulin resistance and hyperinsulinemia rarely exist in isolation in a nondiabetic population. It is difficult to discern an independent impact of hyperinsulinemia on CVD risk factors associated with insulin resistance.

PubMed Disclaimer

Figures

Figure 1—
Figure 1—
Relationship between insulin resistance (SSPG) and insulin response was best expressed as an exponential function (A) or a linear function when insulin response (insulin AUC) was log-transformed (B).
See this image and copyright information in PMC

References

    1. Reaven GM, Olefsky JM: Relationship between heterogeneity of insulin responses and insulin resistance in normal subjects and patients with chemical diabetes. Diabetologia 13:201–206, 1977 - PubMed
    1. Hollenbeck C, Reaven GM: Variations in insulin-stimulated glucose uptake in healthy individuals with normal glucose tolerance. J Clin Endocrinol Metab 64:1169–1173, 1987 - PubMed
    1. Reaven GM: Banting Lecture 1988: Role of insulin resistance in human disease. Diabetes 37:1595–1607, 1988 - PubMed
    1. Kim SH, Abbasi F, Reaven GM: Impact of degree of obesity on surrogate estimates of insulin resistance. Diabetes Care 27:1998–2002, 2004 - PubMed
    1. Welborn TA, Breckenridge A, Rubinstein AH, Dollery CT, Fraser TR: Serum-insulin in essential hypertension and in peripheral vascular disease. Lancet 1:1336–1337, 1966 - PubMed

Publication types