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Insulin Resistance and Cardiometabolic Syndrome: Adipose Tissue and Skeletal Muscle Factors

Skeletal muscle insulin resistance: role of inflammatory cytokines and reactive oxygen species

Departments of ¹Internal Medicine, ²Physiology and Pharmacology, University of Missouri School of Medicine, Columbia, Missouri; ³Harry Truman VA Medical Center, Columbia, Missouri; and ⁴Department of Internal Medicine, University of Arizona, Tucson, Arizona

Submitted 3 August 2007 ; accepted in final form 4 December 2007

The cardiometabolic syndrome (CMS), with its increased risk for cardiovascular disease (CVD), nonalcoholic fatty liver disease (NAFLD), and chronic kidney disease (CKD), has become a growing worldwide health problem. Insulin resistance is a key factor for the development of the CMS and is strongly related to obesity, hyperlipidemia, hypertension, type 2 diabetes mellitus (T2DM), CKD, and NAFLD. Insulin resistance in skeletal muscle is particularly important since it is normally responsible for more than 75% of all insulin-mediated glucose disposal. However, the molecular mechanisms responsible for skeletal muscle insulin resistance remain poorly defined. Accumulating evidence indicates that low-grade chronic inflammation and oxidative stress play fundamental roles in the development of insulin resistance, and inflammatory cytokines likely contribute to the link between inflammation, oxidative stress, and skeletal muscle insulin resistance. Understanding the mechanisms by which skeletal muscle tissue develops resistance to insulin will provide attractive targets for interventions, which may ultimately curb this serious problem. This review is focused on the effects of inflammatory cytokines and oxidative stress on insulin signaling in skeletal muscle and consequent development of insulin resistance.