Age-related insulin resistance: is it an obligatory finding? The lesson from healthy centenarians
Article first published online: 31 JAN 2001
Copyright © 2001 John Wiley & Sons, Ltd.
Diabetes/Metabolism Research and Reviews
Volume 17, Issue 1, pages 19–26, January/February 2001
How to Cite
Barbieri, M., Rosaria Rizzo, M., Manzella, D. and Paolisso, G. (2001), Age-related insulin resistance: is it an obligatory finding? The lesson from healthy centenarians. Diabetes Metab. Res. Rev., 17: 19–26. doi: 10.1002/dmrr.178
- Issue published online: 19 FEB 2001
- Article first published online: 31 JAN 2001
- Manuscript Accepted: 6 OCT 2000
- Manuscript Revised: 3 OCT 2000
- Manuscript Received: 15 JUN 2000
- insulin resistance;
- anthropometric changes;
It is widely known that advancing age is associated with impaired glucose handling. A unifying hypothesis explaining the relationship between aging and insulin resistance might encompass four main pathways, namely: (a) anthropometric changes (relative and absolute increase in body fat combined with a decline in fat free mass) which could be the anatomic substrate for explaining the reduction in active metabolic tissue; (b) environmental causes, mainly diet style and physical activity; (c) neuro-hormonal variations [decline in plasma dehydroepandrosterone sulphate (DHEAS) and IGF-1]; and finally (d) the rise in oxidative stress. Indeed previous studies have also investigated the occurrence and the degree of insulin resistance in healthy centenarians. Such data demonstrated that age-related insulin resistance is not an obligatory finding in the elderly and that healthy centenarians have a preserved insulin action compared to aged subjects. Why insulin action is preserved in centenarians is still not known. Nevertheless, a possible approach to the question is to outline the centenarians' anthropometric, endocrine and metabolic characteristics in order to design a clinical picture of such metabolic ‘successful aging’. According to the remodeling theory of age, the preserved insulin action in centenarians might be the net result of the continuous adaptation of the body to the deleterious changes that occur over time. Nevertheless, only future longitudinal studies specifically designed to investigate the relationship between extreme old age and degree of insulin sensitivity will provide a conclusive answer with regard to the pathophysiology of adaptive metabolic changes occurring in the elderly. Copyright © 2001 John Wiley & Sons, Ltd.