Prevalence of metabolic syndrome and insulin resistance in overweight and obese women according to the different diagnostic criteria.
ABSTRACT Metabolic syndrome (MS) is a cluster of risk factors favoring the development of type 2 diabetes and cardiovascular diseases. The prevalence of MS diagnosis is dependent of used diagnostic criteria. The aim of the study is to compare the prevalence of MS in overweight and obese women without concomitant diseases according to the different diagnostic criteria and their sensitivity to identify subjects with insulin resistance.
The study involved 126 overweight and obese women without concomitant diseases. In all subjects body mass, height, waist circumference and blood pressure were measured and plasma glucose, insulin and lipids levels were determined. MS was diagnosed using WHO, NCEP ATP III, IDF 2005 and IDF 2009 modified criteria. The insulin resistance was assessed based on the homeostatic model assessment insulin resistance (HOMA-IR≥2.5).
The prevalence of MS was 43.8%, 43.8%, 38.1% and 18.1% according to IDF 2005, IDF 2009 modified, NCEP ATP III and WHO criteria, respectively. Insulin resistance was diagnosed in 89 women (70.6%). None of MS definitions allowed for proper discrimination of insulin resistant subjects. The highest sensitivity, but lowest specificity of insulin resistant discrimination had both IDF criteria (44.9% and 72.9%, respectively), while the highest specificity WHO criteria was missing sensitivity (91.8% and 17.9%, respectively).
On the basis of both IDF criteria MS is diagnosed in significantly larger subset of overweight and obese women. However, NCEP ATPIII and both IDF criteria identify only less than half insulin resistant overweight and obese women as those with MS.
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ABSTRACT: The study was designed to assess the association between insulin resistance (IR) and apolipoprotein B/apolipoprotein A-I ratio (ApoB/ApoA-I ratio), metabolic syndrome (MetS) components, total cholesterol (TC), and low-density lipoprotein cholesterol (LDL-C) in the nondiabetic population of Georgia. The subjects were 1522 Georgians of Caucasian origin (mean age = 45 years, 653 women) without diabetes who had visited the clinics for a related health checkup between 2012 and 2013. IR was calculated using the computer homeostasis model assessment (HOMA2-IR) and was defined as the upper quartile. MetS was diagnosed using the updated ATP-III definition of the metabolic syndrome. Logistic and multiple regression models were used to estimate the association between IR and other components. IR was positively correlated with age, ApoB, ApoB/ApoA-I ratio, MetS components (excluding high-density lipoprotein cholesterol-HDL-C), LDL-C, fasting insulin, and TC and negatively correlated with HDL-C and ApoA-I in both sexes (all P < 0.001). In the logistic regression models, gender, age, ApoB/ApoA-I ratio, diastolic pressure, HDL-C, LDL-C, fasting glucose, and triglycerides were the covariates significantly associated with IR (OR: 8.64, 1.03, 17.95, 1.06, 0.13, 1.17, 3.75, and 2.29, resp.; all P < 0.05). Multiple regression models demonstrated that these components (except for HDL-C) made an independent contribution to the prediction of HOMA2 (all P < 0.05).International Journal of Endocrinology 05/2014; 2014:925650. DOI:10.1155/2014/925650 · 1.52 Impact Factor
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ABSTRACT: Background: The hepatitis C virus (HCV) genotype-specific impacts on the host metabolic alterations remained inconclusive. Methods: A prospective study including 229 (118 genotype 1 (G1) and 111 G2) consecutive chronic HCV patients who had completed a course of anti-HCV treatment and underwent pre- and 24 weeks post-treatment surveys of metabolic profiles was conducted. Patients were stratified according to the therapeutic response, viral genotype and baseline insulin resistance (IR: homeostasis model assessments of IR (HOMA-IR) >= 2.5). Paired t-tests were used to compare the pre- and post-treatment variables. Results: Significant post-therapeutic increases in cholesterol, triglyceride, HDL, LDL, apolipoprotein A1 and apolipoprotein B were observed in patients with sustained virological response (SVR) but not in those without. Among those with SVR, post-therapeutic increases in HDL (p < 0.001) and apolipoprotein A1 (p = 0.012) were only found in G2, whereas increased triglyceride/HDL (p = 0.01) ratios were only found in G1 patients. When stratified by baseline IR among those with SVR, a significant increase in post-treatment HDL (p = 0.019) and apolipoprotein A1 (p = 0.012) but a decrease in HOMA-IR (p = 0.04), C-peptide (p = 0.019) and hemoglobin A1c (p = 0.047) were found in patients with baseline IR; a significant increase in HOMA-IR (p = 0.002) was found in patients without baseline IR. The latter change was observed only in G1 (p = 0.01) but not G2 patients. Although the pre-treatment metabolic profiles of G1 and G2 patients were indifferent, G1 had higher post-treatment triglyceride/HDL ratios (p = 0.041) and triglyceride (p = 0.044) levels than G2 patients. Conclusions: G2 benefit more than G1 patients from viral clearance in metabolic alterations, particularly in those without baseline IR.PLoS ONE 08/2014; 9(8):e104783. DOI:10.1371/journal.pone.0104783 · 3.53 Impact Factor
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ABSTRACT: Studies have indicated that ApoB/ApoA-I ratio is significantly associated with MetS and IR. This study was designedto assess the optimal cutoff values of ApolipoproteinB/ApolipoproteinA-I (ApoB/ApoA-I) ratio for the diagnosis of metabolic syndrome and insulin resistance (IR) in the population of Georgia. The subjects were 1522 Georgians of Caucasian origin aged 18-80 (653 women and 869 men) without diabetes mellitus. MetS was diagnosed using the updated ATP-III definition of the metabolic syndrome. Receiver operating characteristics (ROC) curve analysis was performed to calculate the cutoff values. ROC analysis showed that areas under the curve (AUCs) of ApoB/ApoA-I ratio for the detection of MetS were 0.786±0.025 (95%CI: 0.737-0.834) in women and 0.815±0.017 (95%CI: 0.782-0.847) in men. AUCs of ApoB/ApoA-I ratio for the diagnosis of IR were 0.887±0.019 (95%CI: 0.850-0.924) in women and 0.816±0.022 (95%CI: 0.773-0.860) in men. After adjustment for age, MetS components and low-density lipoprotein cholesterol, odds ratios according to the determined cutoff values of ApoB/ApoA-I ratio were: for MetS – 1.75 in women and 1.18 in men; for IR – 13.61 in women and 7.75 in men.International Journal of Sciences: Basic and Applied Research (IJSBAR) 08/2014; 17(2):224-235.