62 1 Journal of Molecular L K Metcalfe et al. Intracellular lipids and insulin 62:1 R65–R82 Endocrinology resistance REVIEW Defining lipid mediators of insulin resistance: controversies and challenges Louise K Metcalfe, Greg C Smith and Nigel Turner Department of Pharmacology, School of Medical Sciences, UNSW Sydney, New South Wales, Australia Correspondence should be addressed to N Turner:
[email protected] Abstract Essential elements of all cells – lipids – play important roles in energy production, Key Words signalling and as structural components. Despite these critical functions, excessive f insulin resistance availability and intracellular accumulation of lipid is now recognised as a major factor f lipids contributing to many human diseases, including obesity and diabetes. In the context f lipidomics of these metabolic disorders, ectopic deposition of lipid has been proposed to have f fatty acid metabolism deleterious effects on insulin action. While this relationship has been recognised for some time now, there is currently no unifying mechanism to explain how lipids precipitate the development of insulin resistance. This review summarises the evidence linking specific lipid molecules to the induction of insulin resistance, describing some of the current Journal of Molecular controversies and challenges for future studies in this field. Endocrinology (2019) 62, R65–R82 Insulin resistance and lipid metabolism Obesity and diabetes are metabolic conditions of metabolism; the non-adipose tissues most essential in increasingly widespread significance to modern these processes are muscle and liver. Tissue desensitisation populations. The global scale and gravity of their to insulin, and the resultant failure of a normal insulin impacts on general health, life expectancy and quality dose to elicit these responses, is known as IR.