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159512 Pathology

A 55-year-old obese woman (body mass index =33 kg/m2) complains of declining visual acuity Funduscopic examination shows peripheral retinal microaneurysms. Urinalysis reveals 3+ proteinuria and 3+ glucosuria. Serum albumin is 3 g/dL, and serum cholesterol is 350 mg/dL. These clinicopathologic findings are best explained by which of the following mechanisms of disease?

AAnti-insulin antibodies
BIncreased peripheral insulin uptake
CIrregular insulin secretion
DPeripheral insulin resistance
Pathology
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