While the metabolic syndrome links insulin resistance with abdominal obesity, elevated cholesterol and high blood pressure, there are several medical other conditions that are associated with insulin resistance specifically. It may be that insulin resistance is the cause of some of these conditions, but this has not yet been proven. Conditions associated with insulin resistance include:
Type 2 Diabetes
Overt diabetes may be the first sign that insulin resistance is present. While it can be noted long before diabetes develops, in cases where there is reluctance or inability to see a physician regularly, insulin resistance can present as type 2 diabetes.
Fatty liver is strongly associated with insulin resistance. The accumulation of fat in the liver is a manifestation of the disordered control of lipids that occurs with insulin resistance. Fatty liver associated with insulin resistance may be mild or severe. Newer evidence suggests that fatty liver may even lead to cirrhosis of the liver and, possibly, liver cancer.
Arteriosclerosis, also known as atherosclerosis, is a process of progressive thickening and hardening of the walls of medium-sized and large arteries. Arteriosclerosis is responsible for:
- coronary artery disease (angina and heart attack)
- peripheral vascular disease
Other risk factors for arteriosclerosis include:
- high levels of "bad" (LDL) cholesterol
- high blood pressure
- family history of arteriosclerosis
Skin lesions include increased skin tags and a condition called acanthosis nigricans - a darkening and thickening of the skin especially in fold areas such as the neckline and axilla. This condition is directly related to the insulin resistance, though the exact mechanism is not known.
- Acanthosis nigricans: Acanthosis nigricans is a cosmetic condition strongly associated with insulin resistance in which there is darkening of the skin in areas where there are creases such as the neck and arm pits.
- Skin tags: Skin tags are also seen with increased frequency in patients with insulin resistance. A skin tag is a common, benign condition which consists of a bit of skin that projects from the surrounding skin and may appear attached to the skin. Skin tags can vary quite a bit in appearance. They may be smooth or irregular, flesh colored or more deeply pigmented, and either simply be raised above the surrounding skin or have a stalk (a peduncle) so that the skin tag hangs from the skin.
Reproductive abnormalities in women
Reproductive abnormalities include difficulty with ovulation and conception (infertility), irregular menses, or a cessation of menses. In contrast, there are no known reproductive abnormalities in men with insulin resistance.
Polycystic ovary disease
Polycystic ovary disease is a hormonal problem that affects young women. It is associated with irregular periods or no periods at all, obesity, and increased growth of body hair.
High male hormone levels, which are produced by the ovaries can been seen in insulin resistance and may play a role in PCOS described above. Why this association occurs is not known, but it's thought that the insulin resistance somehow causes the abnormal ovarian hormone production.
There may be growth affects in insulin resistance due to the high levels of circulating insulin that may be present. While insulin's effects on glucose metabolism may be impaired, it's effects on other mechanisms may be intact (or at least less impaired). Insulin is an anabolic and can exert effects on growth, through a medicator known as insulin- like growth factor -1. Patients may have actual linear growth and a noticeable coarsening of features. The increase incidence of skin tags mentioned above may be through this mechanism as well.
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