Pathogenesis of Atherogenic Dyslipidemia

Scott M. Grundy, MD, PhD.

In This Article

Genetic Insulin Resistance of Adipose Tissue

Some persons appear to have more extreme forms of insulin resistance of adipose tissue, and these individuals are prone to development of atherogenic dyslipidemia and the insulin resistance syndrome. Such persons can have metabolic risk factors with only mild degrees of obesity. The general population of South Asia is particularly susceptible to atherogenic dyslipidemia with even mild degrees of obesity.[59] Insulin resistance seemingly occurs on a genetic basis and is manifest with even mild obesity.[60] Some Caucasians with atherogenic dyslipi-demia appear to have a similar propensity to insulin resistance.[57] The molecular bases underlying genetic forms of insulin resistance have not been uncovered but currently are the subject of intense investigation. It is of interest that most persons who have insulin resistance with only mild obesity have upper body obesity. This finding suggests a close relation between insulin resistance and body fat distribution. It is difficult to know which is primary.


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