Insulin resistance: Risk factors, diagnostic approaches and mathematical models for clinical practice, epidemiological studies, and beyond

IF 5.3 2区 医学 Q1 ENGINEERING, BIOMEDICAL Biocybernetics and Biomedical Engineering Pub Date : 2023-12-26 DOI:10.1016/j.bbe.2023.12.004
Janusz Krzymien , Piotr Ladyzynski
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Abstract

Insulin resistance (IR) is a multifactorial metabolic disorder associated with the development of cardiometabolic syndrome, cardiovascular diseases and obesity. Factors such as inflammation, hyperinsulinemia, hyperglucagonemia, mitochondrial dysfunction, glucotoxicity and lipotoxicity contribute to the development of IR. Despite being extensively studied for over 60 years, assessing the incidence of IR, developing effective prevention strategies, and implementing appropriate therapeutic approaches remain challenging. This review explores the multifaceted nature of IR, including its association with various conditions such as obesity, primary hypertension, dyslipidemia, obstructive sleep apnea, Alzheimer's disease, non-alcoholic fatty liver disease, polycystic ovary syndrome, chronic kidney disease and cancer. Additionally, we discuss the complexity of diagnosing and quantifying IR, emphasizing the lack of absolute, common criteria for classification. We delve into the use of mathematical models in clinical and epidemiological studies, focusing on the choice between insulin, triglycerides, or waist-to-hip ratio as IR determinants. Furthermore, we highlight the importance of reliable input data and caution in interpreting results when utilizing mathematical models for IR assessment. This narrative review aims to provide insights into the challenges and considerations involved in conducting IR diagnostics, with implications for clinical practice, epidemiological research, and future advancements in this field.

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胰岛素抵抗:临床实践、流行病学研究及其他方面的风险因素、诊断方法和数学模型
胰岛素抵抗(IR)是一种多因素代谢紊乱,与心血管代谢综合征、心血管疾病和肥胖症的发生有关。炎症、高胰岛素血症、高胰高血糖素血症、线粒体功能障碍、葡萄糖毒性和脂肪毒性等因素都会导致胰岛素抵抗的发生。尽管 60 多年来对 IR 进行了广泛的研究,但评估 IR 的发病率、制定有效的预防策略和实施适当的治疗方法仍具有挑战性。本综述探讨了 IR 的多面性,包括它与肥胖、原发性高血压、血脂异常、阻塞性睡眠呼吸暂停、阿尔茨海默病、非酒精性脂肪肝、多囊卵巢综合征、慢性肾病和癌症等各种疾病的关联。此外,我们还讨论了诊断和量化 IR 的复杂性,强调缺乏绝对、通用的分类标准。我们深入探讨了数学模型在临床和流行病学研究中的应用,重点关注胰岛素、甘油三酯或腰臀比作为 IR 决定因素的选择。此外,我们还强调了可靠输入数据的重要性,以及在利用数学模型进行 IR 评估时谨慎解释结果的重要性。这篇叙述性综述旨在深入探讨进行红外诊断所面临的挑战和需要考虑的因素,并对临床实践、流行病学研究和该领域的未来发展产生影响。
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来源期刊
CiteScore
16.50
自引率
6.20%
发文量
77
审稿时长
38 days
期刊介绍: Biocybernetics and Biomedical Engineering is a quarterly journal, founded in 1981, devoted to publishing the results of original, innovative and creative research investigations in the field of Biocybernetics and biomedical engineering, which bridges mathematical, physical, chemical and engineering methods and technology to analyse physiological processes in living organisms as well as to develop methods, devices and systems used in biology and medicine, mainly in medical diagnosis, monitoring systems and therapy. The Journal''s mission is to advance scientific discovery into new or improved standards of care, and promotion a wide-ranging exchange between science and its application to humans.
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