To summarize the role of insulin in the metabolic syndrome X or the insulin-resistance syndrome. The first part focuses on genetic, environmental, ethnic, and lifestyle factors that contribute to variability in insulin action among populations. The second part covers the pathogenesis of the metabolic syndrome X, with a chapter on each target site for insulin action the insulin receptor, skeletal muscle, liver, adipose tissue, and endothelium. The final section discusses clinical syndromes in persons with insulin resistance, with chapters on lipid disorders, hypertension, albuminuria, coronary heart disease, and the polycystic ovary syndrome. Each section stands out as an in-depth review of the literature on each topic.
Subject matter overlaps little among the chapters, and each chapter can be read independently.
Each author or group of authors strives to present a balanced overview of the data by including studies that contradict as well as those that support the role of insulin resistance in the pathogenesis of the clinical manifestations of the insulin-resistance syndrome. Familiarity with the metabolic syndrome X and recall of the pathways for glucose and lipid metabolism are assumed. A generalized overview and an overview of insulin regulation of carbohydrate and lipid metabolism, with appropriate figures and a glossary, would make the book accessible to a wider audience. Mary T. Korytkowski, MD, University of Pittsburgh, Pittsburgh, Pennsylvania. Note 2 Headache and Facial Pain Mongini F. 284 pages.