Homeostastic Model Assessment and Insulin Sensitivity/Resistance

摘要

Homeostasis is the manifestation of a large network of integrated metabolic reactions and signaling pathways designed to maintain life and function in a stable manner. Insulin is an integral part of this regulatory network and affects virtually all its parts. The actions of insulin vary in time (1) as well as in the various tissues it affects as demonstrated, for example, by selective receptor deletion studies (2). Moreover, insulin individually affects a large number of reactions within these tissues. Lack of insulin, or of its action(s), results in diabetes. This has historically been viewed from the perspective of glucose metabolism, although, as pointed out by McGarry (3), a similar spectrum of deficiencies would have been identified first if lipids had been the primary focus of investigation. Insulin action as an entity is therefore, necessarily, ill-defined. It is embedded within the network of reactions and signals where it plays critical regulatory roles.