Metabolic inflammation: connecting obesity and insulin resistance

Ann Med. 2013 May;45(3):242-53. doi: 10.3109/07853890.2012.705015. Epub 2012 Jul 26.

Abstract

Insulin resistance is a pathological condition that arises when insulin signaling is impaired, forcing β-cells to produce more insulin in order to cope with body demands and to maintain glucose homeostasis. When the pancreas is no more able to support an appropriate insulin secretion, insulin resistance becomes decompensated and hyperglycemia is detected. One of the mechanisms leading to insulin resistance is low-grade inflammation that involves a number of protagonists such as inflammatory cytokines, lipids and their metabolites, reactive oxygen species (ROS), hypoxia and endoplasmic reticulum stress, and changes in gut microbiota profiles. We review here the molecular aspects of metabolic inflammation converging to insulin resistance and secondarily to type 2 diabetes. We also discuss the place of high-sensitivity C-reactive protein (hsCRP) in the assessment of metabolic inflammation and potential therapeutic interventions aimed to impede inflammation and therefore prevent insulin resistance.

Publication types

  • Review

MeSH terms

  • Adipose Tissue / metabolism
  • Anti-Inflammatory Agents, Non-Steroidal / therapeutic use
  • Anticholesteremic Agents / therapeutic use
  • Biomarkers / blood
  • C-Reactive Protein / analysis
  • CD11 Antigens / metabolism
  • Cardiovascular Diseases / blood
  • Cytokines / metabolism
  • Diabetes Mellitus, Type 2 / metabolism*
  • Endoplasmic Reticulum Stress / physiology
  • Glucose / metabolism
  • Humans
  • Hypoglycemic Agents / therapeutic use
  • Hypoxia-Inducible Factor 1, alpha Subunit / metabolism
  • Inflammation / metabolism*
  • Insulin Resistance / physiology*
  • Intestines / microbiology
  • Lipid Metabolism
  • Lymphocytes / metabolism
  • Macrophages / metabolism
  • Mast Cells / metabolism
  • Obesity / metabolism*
  • PPAR gamma / metabolism
  • Unfolded Protein Response / physiology

Substances

  • Anti-Inflammatory Agents, Non-Steroidal
  • Anticholesteremic Agents
  • Biomarkers
  • CD11 Antigens
  • Cytokines
  • Hypoglycemic Agents
  • Hypoxia-Inducible Factor 1, alpha Subunit
  • PPAR gamma
  • C-Reactive Protein
  • Glucose