caa a22 4500 477084192 CHVBK 20180405111458.0 cr unu---uuuuu 170330e19960501xx s 000 0 eng 10.1007/BF01919311 doi (NATIONALLICENCE)springer-10.1007/BF01919311 Schrezenmeir J. III. Medical Clinic, Johannes-Gutenberg University, D-55099, Mainz, (Germany) aut Hyperinsulinemia, hyperproinsulinemia and insulin resistance in the metabolic syndrome [Elektronische Daten] [J. Schrezenmeir] For better comprehension of the metabolic syndrome, it is necessary to differentiate the effect of insulin on glucose metabolism on the one hand, and on other metabolic activities on the other hand. Whereas glucose utilization is affected by insulin resistance, the effect of insulin on lipid metabolism, ion and aminoacid transport does not seem to be diminished. Lipid metabolism, however, seems to play a crucial role in the induction of the vicious cycle. Increased energy and fat ingestion may be due to an increased number of galanin secreting cells in the hypothalamus. The excessive fat intake results in an increased rate of release of insulin and increased influx of triglycerides into the blood. From these triglycerides an excess of free fatty acids is released by the action of lipoprotein lipase. The increased plasma free fatty acid level then results in insulin resistance affecting glucose metabolism. Also, these free fatty acids may impair the secretion of insulin. Induction of insulin resistance results in higher glucose levels, which may cause hyperinsulinemia. Hyperinsulinemia maintains the elevation of triglycerides. When diabetes becomes overt and elevated glucose levels prevail, the hyperinsulinism acts on the metabolic pathways which are still sensitive to insulin, namely lipid metabolism, aminoacid transport and ion transport. Birkhäuser Verlag, 1996 Insulin nationallicence proinsulin nationallicence insulin resistance nationallicence metabolic syndrome nationallicence triglycerides nationallicence free fatty acids nationallicence fat intake nationallicence galanin nationallicence HDL : high density lipoproteins nationallicence NIDDM : non-insulin dependent diabetes mellitus nationallicence oGTT : oral glucose tolerance test nationallicence oMTT : oral metabolic tolerance test nationallicence VLDL : very low density lipoproteins nationallicence WHR : waist-hip ratio nationallicence Experientia Birkhäuser-Verlag 52/5(1996-05-01), 426-432 0014-4754 52:5<426 1996 52 18 https://doi.org/10.1007/BF01919311 text/html Onlinezugriff via DOI 1 review-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/BF01919311 text/html Onlinezugriff via DOI NATIONALLICENCE 100 1- Schrezenmeir J. III. Medical Clinic, Johannes-Gutenberg University, D-55099, Mainz, (Germany) aut NATIONALLICENCE 773 0- Experientia Birkhäuser-Verlag 52/5(1996-05-01), 426-432 0014-4754 52:5<426 1996 52 18 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer