{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T08:42:42Z","timestamp":1792226562570,"version":"4.4.0"},"reference-count":52,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2022,7,10]],"date-time":"2022-07-10T00:00:00Z","timestamp":1657411200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Insulin resistance (IR) has become a common health issue in medical practice. There are no detailed data on IR prevalence, but it is an increasing problem due to its close association with obesity. However, IR is not considered as a separate nosological entity and the diagnostic criteria are not well defined, which leads to overdiagnosis of IR and an inappropriate approach. This review aims to summarize the available literature on IR pathophysiology, its relationship with obesity, as well as diagnostic methods, clinical presentation and treatment. Excessive energy intake results in cell overload that triggers mechanisms to protect cells from further energy accumulation by reducing insulin sensitivity. Additionally, hypertrophied adipocytes and macrophage infiltration causes local inflammation that may result in general inflammation that induces IR. The clinical picture varies from skin lesions (e.g., acanthosis nigricans) to metabolic disorders such as diabetes mellitus or metabolic-associated fatty liver disease. There are numerous IR laboratory markers with varying sensitivities and specificities. Nutrition changes and regular physical activity are crucial for IR management because a reduction in adipose tissue may reverse the inflammatory state and consequently reduce the severity of insulin resistance. In cases of obesity, anti-obesity medications can be used.<\/jats:p>","DOI":"10.3390\/diagnostics12071681","type":"journal-article","created":{"date-parts":[[2022,7,10]],"date-time":"2022-07-10T21:19:28Z","timestamp":1657487968000},"page":"1681","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":48,"title":["Link between Insulin Resistance and Obesity\u2014From Diagnosis to Treatment"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8502-3030","authenticated-orcid":false,"given":"Jakub","family":"Go\u0142acki","sequence":"first","affiliation":[{"name":"Department of Endocrinology, Diabetology and Metabolic Diseases, Medical University of Lublin, Jaczewskiego 8, 20-954 Lublin, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5691-6032","authenticated-orcid":false,"given":"Ma\u0142gorzata","family":"Matuszek","sequence":"additional","affiliation":[{"name":"Student\u2019s Scientific Society at the Department of Endocrinology, Diabetology and Metabolic Diseases, Medical University of Lublin, 20-954 Lublin, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7386-8087","authenticated-orcid":false,"given":"Beata","family":"Matyjaszek-Matuszek","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Diabetology and Metabolic Diseases, Medical University of Lublin, Jaczewskiego 8, 20-954 Lublin, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,7,10]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1154","DOI":"10.1210\/js.2018-00342","article-title":"A Simple and Improved Predictor of Insulin Resistance Extracted From the Oral Glucose Tolerance Test: The I0*G60","volume":"3","author":"Contreras","year":"2019","journal-title":"J. Endocr. Soc."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"277","DOI":"10.1007\/978-3-319-48382-5_12","article-title":"Insulin Resistance, Obesity and Lipotoxicity","volume":"960","author":"Sezer","year":"2017","journal-title":"Adv. Exp. Med. Biol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"25","DOI":"10.2478\/folmed-2013-0002","article-title":"Adipose tissue hormones and appetite and body weight regulators in insulin resistance","volume":"55","author":"Koleva","year":"2013","journal-title":"Folia Med. (Plovdiv)"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"568","DOI":"10.3389\/fendo.2019.00568","article-title":"Obesity as the Main Risk Factor for Metabolic Syndrome in Children","volume":"10","author":"Gepstein","year":"2019","journal-title":"Front. Endocrinol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"665","DOI":"10.1016\/j.beem.2006.09.007","article-title":"Pathophysiology of Insulin Resistance","volume":"20","author":"Sesti","year":"2006","journal-title":"Best Pract. Res. Clin. Endocrinol. Metab."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"5009","DOI":"10.1128\/MCB.00797-10","article-title":"Insulin Regulates Adipocyte Lipolysis via an Akt-Independent Signaling Pathway","volume":"30","author":"Choi","year":"2010","journal-title":"Mol. Cell. Biol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"2273","DOI":"10.1083\/jcb.201802095","article-title":"The Cell Biology of Systemic Insulin Function","volume":"217","author":"Tokarz","year":"2018","journal-title":"J. Cell Biol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1007\/s11906-018-0880-0","article-title":"Visceral Adipose Tissue Accumulation and Residual Cardiovascular Risk","volume":"20","author":"Samson","year":"2018","journal-title":"Curr. Hypertens. Rep."},{"key":"ref_9","first-page":"715","article-title":"Review Visceral and Ectopic Fat, Atherosclerosis, and Cardiometabolic Disease: A Position Statement","volume":"7","author":"Neeland","year":"2019","journal-title":"Diabetes-Endocrinol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1111\/j.1467-789X.2009.00623.x","article-title":"Subcutaneous and Visceral Adipose Tissue: Structural and Functional Differences","volume":"11","author":"Ibrahim","year":"2010","journal-title":"Obes. Rev."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1793","DOI":"10.1172\/JCI29069","article-title":"Inflammation and Insulin Resistance","volume":"116","author":"Shoelson","year":"2006","journal-title":"J. Clin. Investig."},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Kojta, I., Chaci\u0144ska, M., and B\u0142achnio-Zabielska, A. (2020). Obesity, Bioactive Lipids, and Adipose Tissue Inflammation in Insulin Resistance. Nutrients, 12.","DOI":"10.3390\/nu12051305"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"111315","DOI":"10.1016\/j.biopha.2021.111315","article-title":"Adipose Tissue and Insulin Resistance in Obese","volume":"137","author":"Ahmed","year":"2021","journal-title":"Biomed. Pharmacother."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"e12997","DOI":"10.1111\/eci.12997","article-title":"Adipokine Dysregulation and Adipose Tissue Inflammation in Human Obesity","volume":"48","author":"Unamuno","year":"2018","journal-title":"Eur. J. Clin. Investig."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"2240","DOI":"10.1210\/jc.2006-1811","article-title":"Macrophage Infiltration into Omental Versus Subcutaneous Fat across Different Populations: Effect of Regional Adiposity and the Comorbidities of Obesity","volume":"92","author":"Redel","year":"2007","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"2277","DOI":"10.2337\/diabetes.54.8.2277","article-title":"Reduction of Macrophage Infiltration and Chemoattractant Gene Expression Changes in White Adipose Tissue of Morbidly Obese Subjects After Surgery-Induced Weight Loss","volume":"54","author":"Cancello","year":"2005","journal-title":"Diabetes"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"E961","DOI":"10.1152\/ajpendo.00506.2005","article-title":"Diet and Exercise Reduce Low-Grade Inflammation and Macrophage Infiltration in Adipose Tissue but Not in Skeletal Muscle in Severely Obese Subjects","volume":"290","author":"Bruun","year":"2006","journal-title":"Am. J. Physiol. -Endocrinol. Metab."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"197","DOI":"10.1007\/978-3-319-48382-5_8","article-title":"What Is Lipotoxicity?","volume":"960","author":"Engin","year":"2017","journal-title":"Adv. Exp. Med. Biol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"139","DOI":"10.1097\/MED.0b013e3283444b09","article-title":"45Obesity, Insulin Resistance and Free Fatty Acids","volume":"18","author":"Boden","year":"2011","journal-title":"Curr. Opin. Endocrinol. Diabetes Obes."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1900\/RDS.2008.5.13","article-title":"The Role of Skeletal Muscle Sphingolipids in the Development of Insulin Resistance","volume":"5","author":"Straczkowski","year":"2008","journal-title":"Rev. Diabet. Stud."},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Blachnio-Zabielska, A.U., Hady, H.R., Markowski, A.R., Kurianiuk, A., Karwowska, A., G\u00f3rski, J., and Zabielski, P. (2018). Inhibition of Ceramide De Novo Synthesis Affects Adipocytokine Secretion and Improves Systemic and Adipose Tissue Insulin Sensitivity. Int. J. Mol. Sci., 19.","DOI":"10.3390\/ijms19123995"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"a009191","DOI":"10.1101\/cshperspect.a009191","article-title":"Insulin Receptor Signaling in Normal and Insulin-Resistant States","volume":"6","author":"Boucher","year":"2014","journal-title":"Cold Spring Harb. Perspect. Biol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"303","DOI":"10.1080\/09637480500195066","article-title":"Six Reasons Why the Waist-to-Height Ratio Is a Rapid and Effective Global Indicator for Health Risks of Obesity and How Its Use Could Simplify the International Public Health Message on Obesity","volume":"56","author":"Ashwell","year":"2009","journal-title":"Int. J. Food Sci. Nutr."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1857","DOI":"10.1111\/jocd.13544","article-title":"Acanthosis Nigricans: A Review","volume":"19","author":"Das","year":"2020","journal-title":"J. Cosmet. Dermatol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"255","DOI":"10.4103\/0974-7753.111215","article-title":"Keratosis Pilaris Revisited: Is It More Than Just a Follicular Keratosis?","volume":"4","author":"Thomas","year":"2012","journal-title":"Int. J. Trichology"},{"key":"ref_26","unstructured":"(2022, March 18). Consensus Statements. Available online: https:\/\/www.idf.org\/e-library\/consensus-statements\/60-idfconsensus-worldwide-definitionof-the-metabolic-syndrome.html."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"178","DOI":"10.1016\/j.adengl.2013.09.006","article-title":"Skin Disorders in Overweight and Obese Patients and Their Relationship with Insulin","volume":"105","year":"2014","journal-title":"Actas Dermo-Sifiliogr\u00e1ficas"},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Poznyak, A., Grechko, A.V., Poggio, P., Myasoedova, V.A., Alfieri, V., and Orekhov, A.N. (2020). Molecular Sciences The Diabetes Mellitus-Atherosclerosis Connection: The Role of Lipid and Glucose Metabolism and Chronic Inflammation. Int. J. Mol. Sci., 21.","DOI":"10.3390\/ijms21051835"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"3320","DOI":"10.2337\/diacare.26.12.3320","article-title":"Diagnosing Insulin Resistance by Simple Quantitative Methods in Subjects with Normal Glucose Metabolism","volume":"26","author":"Ascaso","year":"2003","journal-title":"Diabetes Care"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"187","DOI":"10.5507\/bp.2019.021","article-title":"Indirect Insulin Resistance Detection: Current Clinical Trends and Laboratory Limitations","volume":"163","author":"Placzkowska","year":"2019","journal-title":"Biomed. Pap. Med. Fac. Univ. Palacky. Olomouc Czech Repub"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1152\/ajpendo.00645.2007","article-title":"Current Approaches for Assessing Insulin Sensitivity and Resistance in Vivo: Advantages, Limitations, and Appropriate Usage","volume":"294","author":"Muniyappa","year":"2008","journal-title":"Am. J. Physiol. Endocrinol. Metab."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"460","DOI":"10.2337\/diacare.24.3.460","article-title":"Diagnosing Insulin Resistance in the General Population","volume":"24","author":"Mcauley","year":"2001","journal-title":"Diabetes Care"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"98","DOI":"10.3109\/00365510903544585","article-title":"Insulin Sensitivity (Si) Assessment in Lean and Overweight Subjects Using Two Different Protocols and Updated Software","volume":"70","author":"Borai","year":"2010","journal-title":"Scand. J. Clin. Lab. Investig."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1901","DOI":"10.1038\/oby.2008.307","article-title":"Hyperbolic Relationship Between Insulin Secretion and Sensitivity on Oral Glucose Tolerance Test","volume":"16","author":"Retnakaran","year":"2008","journal-title":"Obesity"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"412","DOI":"10.1007\/BF00280883","article-title":"Homeostasis Model Assessment: Insulin Resistance and \u03b2-Cell Function from Fasting Plasma Glucose and Insulin Concentrations in Man","volume":"28","author":"Matthews","year":"1985","journal-title":"Diabetologia"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"2191","DOI":"10.2337\/diacare.21.12.2191","article-title":"Correct Homeostasis Model Assessment (HOMA) Evaluation Uses the Computer Program","volume":"21","author":"Levy","year":"1998","journal-title":"Diabetes Care"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"188","DOI":"10.4082\/kjfm.2016.37.3.188","article-title":"Comparison of Surrogate Markers as Measures of Uncomplicated Insulin Resistance in Korean Adults","volume":"37","author":"Kim","year":"2016","journal-title":"Korean J. Fam. Med."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"2094","DOI":"10.1016\/j.dsx.2019.04.044","article-title":"Proinsulin\/Insulin Ratio as a Predictor of Insulin Resistance and B-Cell Dysfunction in Obese Egyptians ((Insulin Resistance & B-Cell Dysfunction in Obese Egyptians))","volume":"13","author":"Abdelsalam","year":"2019","journal-title":"Diabetes Metab. Syndr. Clin. Res. Rev."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"2389","DOI":"10.2337\/db18-0279","article-title":"Increased \u03b2-Cell Workload Modulates Proinsulin-to-Insulin Ratio in Humans","volume":"67","author":"Mezza","year":"2018","journal-title":"Diabetes"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"248","DOI":"10.26444\/aaem\/109225","article-title":"Estimation of Reference Intervals of Insulin Resistance (HOMA), Insulin Sensitivity (Matsuda), and Insulin Secretion Sensitivity Indices (ISSI-2) in Polish Young People","volume":"27","author":"Kokot","year":"2020","journal-title":"Ann. Agric. Environ. Med."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"665292","DOI":"10.3389\/fendo.2021.665292","article-title":"Nuclear Magnetic Resonance Derived Biomarkers for Evaluating Cardiometabolic Risk in Youth and Young Adults Across the Spectrum of Glucose Tolerance","volume":"12","author":"Chung","year":"2021","journal-title":"Front. Endocrinol."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"321","DOI":"10.1111\/cen.12086","article-title":"Sex Hormone Binding Globulin and Insulin Resistance","volume":"78","author":"Wallace","year":"2012","journal-title":"Clin. Endocrinol."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"89","DOI":"10.2337\/dc06-1519","article-title":"Muscle and Liver Insulin Resistance Indexes Derived From the Oral Glucose Tolerance Test","volume":"30","author":"Matsuda","year":"2007","journal-title":"Diabetes Care"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1007\/s00125-015-3776-4","article-title":"The Insulin Resistance Phenotype (Muscle or Liver) Interacts with the Type of Diet to Determine Changes in Disposition Index after 2 Years of Intervention: The CORDIOPREV-DIAB Randomised Clinical Trial","volume":"59","author":"Wopereis","year":"2016","journal-title":"Diabetologia"},{"key":"ref_45","first-page":"3230","article-title":"The Finnish Diabetes Prevention Study (DPS) Lifestyle intervention and 3-year results on diet and physical activity","volume":"26","author":"Lindstrom","year":"2003","journal-title":"Diabetes Care"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"353","DOI":"10.1249\/MSS.0000000000002800","article-title":"Exercise\/Physical Activity in Individuals with Type 2 Diabetes: A Consensus Statement from the American College of Sports Medicine","volume":"54","author":"Kanaley","year":"2022","journal-title":"Med. Sci. Sports Exerc."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"656909","DOI":"10.3389\/fphys.2021.656909","article-title":"Exercising for Insulin Sensitivity\u2014Is There a Mechanistic Relationship with Quantitative Changes in Skeletal Muscle Mass?","volume":"12","author":"Paquin","year":"2021","journal-title":"Front. Physiol."},{"key":"ref_48","unstructured":"Boul\u00e9, N.G., and Prud\u2019homme, D. (2022, May 13). Canadian Adult Obesity Clinical Practice Guidelines: Physical Activity in Obesity Management. Available online: https:\/\/obesitycanada.ca\/guidelines\/physicalactivity."},{"key":"ref_49","unstructured":"Pedersen, S.D., Manjoo, P., and Wharton, S. (2022, May 18). Canadian Adult Obesity Clinical Practice Guidelines: Pharmacotherapy in Obesity Management. Available online: https:\/\/obesitycanada.ca\/guidelines\/pharmacotherapy."},{"key":"ref_50","doi-asserted-by":"crossref","unstructured":"Tang, T., Norman, R.J., Balen, A.H., and Lord, J.M. (2003). Insulin-Sensitising Drugs (Metformin, Troglitazone, Rosiglitazone, Pioglitazone, D-Chiro-Inositol) for Polycystic Ovary Syndrome. Cochrane Database Syst. Rev.","DOI":"10.1002\/14651858.CD003053"},{"key":"ref_51","doi-asserted-by":"crossref","unstructured":"Diabetes Prevention Program Research Group (2002). Reduction in the Incidence of Type 2 Diabetes with Lifestyle Intervention or Metformin. N. Engl. J. Med., 346, 393.","DOI":"10.1056\/NEJMoa012512"},{"key":"ref_52","doi-asserted-by":"crossref","unstructured":"Szuli\u0144ska, M., \u0141oniewski, I., van Hemert, S., Sobieska, M., and Bogda\u0144ski, P. (2018). Dose-Dependent Effects of Multispecies Probiotic Supplementation on the Lipopolysaccharide (LPS) Level and Cardiometabolic Profile in Obese Postmenopausal Women: A 12-Week Randomized Clinical Trial. Nutrients, 10.","DOI":"10.3390\/nu10060773"}],"container-title":["Diagnostics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4418\/12\/7\/1681\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T23:47:41Z","timestamp":1760140061000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4418\/12\/7\/1681"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,7,10]]},"references-count":52,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2022,7]]}},"alternative-id":["diagnostics12071681"],"URL":"https:\/\/doi.org\/10.3390\/diagnostics12071681","relation":{},"ISSN":["2075-4418"],"issn-type":[{"value":"2075-4418","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,7,10]]}}}