Pancreatic Islet Pathophysiology And Pathology In Obesity

The term metabolic syndrome embraces a complex array of metabolic in-balances that are all interrelated (1,2). This includes abnormal insulin secretion that, in obesity, is usually in the form of hypersecretion of insulin associated with increased insulin resistance. Whether the association of all of the metabolic defects represents a true clinical syndrome remains controversial (3). However, the disturbances in the circulating and local concentrations of cellular fuels, hormones, and metabolic intermediates have a significant impact on pancreatic islet function and pathology. In many susceptible individuals, the resulting deteriorating pancreatic function results in type 2 diabetes. This chapter describes some of the pathological features present in the pancreas in obese individuals, the roles of lipids in islet cell function and survival, and the potential consequences of sustained increased insulin resistance and hyperlipidemia for islet cell function.