Abstract

CANO, Raquel et al. FROMOBESITYTODIABETES:INSULIN-RESISTANCE IS A DEFENSE MECHANISM AND NOT A DISEASE ABSTRACT. Rev. Venez. Endocrinol. Metab. [online]. 2017, vol.15, n.1, pp.20-28. ISSN 1690-3110.

The storage capacity of adiposetissueislimitedand determined genetically, so therearethin people with small storage capacity that have altered metabolic markers (hyperinsulinemia, hyperglycemia, dyslipidemia, hepatic steatosis, etc.), and other people with large storage capacity that are able to increase weight until becoming morbidly obese and yet have normal metabolic markers. As adipose tissue approaches its maximum storage capacity, the adipocyte becomes less sensitive to insulin, to avoid death by apoptosis due to excessive accumulation of triglycerides (TG). The degree of insulin resistance (IR) in the adipose tissue and its duration determines three different situations. First of all, the patient increases weight. Second, the patient remains in a constant weight, since the amount of stored TG equals the amount that is hydrolyzed. And finally, when the IR is permanent, Type 2 Diabetes Mellitus (DM2) develops, causing weight loss and altered metabolic markers. Adipose tissue IR increases circulating free fatty acids, which have three destinations: liver, where they accumulate causing steatosis; pancreatic beta cell, which undergoes apoptosis and decreases synthesis and secretion of insulin; and skeletal muscle which develops IR to protect itself against an abnormal accumulation of glycogen that would lead to degeneration and death of the muscle cell. This article explains the molecular modifications that these organs use to maintain their indemnity.

Keywords : Insulin resistance; obesity; diabetes; adipocyte.

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