Juraj Hrnčiar
Basic aetiopathogenetic link of the insulin resistance syndrome is congenital and by means of various mechanisms gradually deepening insulin resistance that must be compensated by hypersecretion of insulin. To measure insulin resistance or sensitivity, various insulin sensitivity indices have been developed for clinical practice and population studies that were calculated from basal insulin and glycaemia values or from values obtained from oGTT. Compensatory hyperinsulinism through stimulation of contraregulatory hormones and expression of various genes mediates gradual onset of all phenomena of the insulin resistance syndrome. Finally, at middle and elder age developed insulin resistance syndrome represents the agglomeration of main risk factors accelerating the process of atherothrombogenesis with subsequent high cardiovascular morbidity, invalidity and mortality.