Insulin resistance is mainly characteristic for type 2 diabetes, a common disorder that is also a potent risk factor for coronary heart disease. Genetic associations with type 2 diabetes have recently been drawn, and genes underlying rare monogenic causes of insulin resistance have been identified. But the molecular basis of the common insulin resistance remains unknown.

In 3 March Lancet, Koji Miyaoka and colleagues from Osaka University, Japan present evidence for insulin resistance in CD36-deficient people. Miyaoka et al used the euglycaemic hyperinsulinaemic clamp technique and found insulin resistance in the five CD36-deficient people tested (Lancet 2001, 357:686-687).

CD36 is a multifunctional receptor, which plays a part in mediating intracellular signalling as well as in taking up long-chain fatty acids. This may explain CD36 involvement in the insulin resistance mechanism.

Genetic CD36 deficiency is common in Asian and African populations and could be responsible for the...

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