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Review
. 2019 Jul 24;3(9):1727-1747.
doi: 10.1210/js.2019-00065. eCollection 2019 Sep 1.

Hyperinsulinemia: An Early Indicator of Metabolic Dysfunction

Dylan D Thomas  1 , Barbara E Corkey  1 , Nawfal W Istfan  1 , Caroline M Apovian  1
Affiliations
Review

Hyperinsulinemia: An Early Indicator of Metabolic Dysfunction

Dylan D Thomas et al. J Endocr Soc. .

Abstract

Hyperinsulinemia is strongly associated with type 2 diabetes. Racial and ethnic minority populations are disproportionately affected by diabetes and obesity-related complications. This mini-review provides an overview of the genetic and environmental factors associated with hyperinsulinemia with a focus on racial and ethnic differences and its metabolic consequences. The data used in this narrative review were collected through research in PubMed and reference review of relevant retrieved articles. Insulin secretion and clearance are regulated processes that influence the development and progression of hyperinsulinemia. Environmental, genetic, and dietary factors are associated with hyperinsulinemia. Certain pharmacotherapies for obesity and bariatric surgery are effective at mitigating hyperinsulinemia and are associated with improved metabolic health. Hyperinsulinemia is associated with many environmental and genetic factors that interact with a wide network of hormones. Recent studies have advanced our understanding of the factors affecting insulin secretion and clearance. Further basic and translational work on hyperinsulinemia may allow for earlier and more personalized treatments for obesity and metabolic diseases.

Keywords: diabetes; hyperinsulinemia; hypersecretion; insulin clearance.

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Conflict of interest statement

Disclosure Summary: C.M.A. reports grants from Aspire Bariatrics, the Vela Foundation, Coherence Laboratory, Energesis, NIH, and PCORI; grants and personal fees from GI Dynamics, Takeda, Novo Nordisk, and Gelesis; and personal fees from Orexigen, EnteroMedics, Nutrisystem, Zafgen, Sanofi-Aventis, Scientific Intake, Xeno Biosciences, Rhythm Pharmaceuticals, Eisai, and Bariatrix Nutrition and other fees from Science-Smart LLC, outside the submitted work. The remaining authors have nothing to disclose.Data sharing is not applicable to this article as no data sets were generated or analyzed during the current study.

Figures

Figure 1.
Figure 1.
Diagram of multifactorial etiologies of hyperinsulinemia. Interactions between these various risk factors may also contribute to its development and progression.
Figure 2.
Figure 2.
Diagram of potential mechanisms for hyperinsulinemia with altered insulin pulsatility to induce metabolic disease. Chronic hyperinsulinemia of any potential etiology is associated with chronic hyperglucagonemia, which may lead to increased hepatic glucose output. Nutrient excess and hyperlipidemia contribute to adipose tissue expansion and dysfunction with eventual ectopic lipid deposition, which is associated with reduced muscle glucose disposal.
See this image and copyright information in PMC

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