Insulin Resistance: Current State of Knowledge and Clinical Implications-Toward a Better Diagnostic Framework and the Question of Its Disease Status.
Level 5 - mechanism / opinion, no new human data
Narrative review synthesizing existing literature without systematic search methodology.
PubMed 42654246 · doi:10.3390/nu18162666
What was done
The authors conducted a narrative review of clinical, epidemiological, and mechanistic literature identified via PubMed and Google Scholar, including meta-analyses, systematic reviews, observational studies, clinical guidelines, and expert position statements. Animal studies were excluded. The paper evaluated the pathophysiology of insulin resistance, diagnostic tools (hyperinsulinemic-euglycemic clamp, HOMA-IR, OGTT with insulin, TyG index, TG/HDL-C ratio), and the rationale for classifying it as a distinct disease entity.
What was found
The reported global prevalence of insulin resistance ranges from approximately 15.5% to over 61%, varying by population and diagnostic method applied. Insulin resistance is described as contributing to type 2 diabetes, cardiovascular disease, metabolic dysfunction-associated steatotic liver disease, cellular senescence, certain cancers, and neuropsychiatric disorders. The abstract provides no quantitative effect estimates or pooled diagnostic test accuracy numbers.
Why it matters
The review argues that standardizing diagnostic criteria and formalizing insulin resistance as a recognized disease entity could enable earlier detection and intervention before the onset of downstream metabolic complications.
Limits
As a narrative review, the synthesis lacks a systematic search protocol, formal quality appraisal, and meta-analytic pooling. The abstract does not report the total number of reviewed studies or provide quantitative performance metrics for the discussed diagnostic surrogates.
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