Article

Hyperinsulinemia: The key feature of a cardiovascular and metabolic syndrome

Department of Medicine, University of Texas Health Science Center, San Antonio.
Diabetologia (Impact Factor: 6.67). 07/1991; 34(6):416-22. DOI: 10.1007/BF00403180
Source: PubMed

ABSTRACT

In a population-based survey of 2,930 subjects, prevalence rates for obesity, Type 2 (non-insulin-dependent) diabetes mellitus, impaired glucose tolerance, hypertension, hypertriglyceridaemia, and hypercholesterolaemia were 54.3, 9.3, 11.1, 9.8, 10.3 and 9.2%, respectively. The prevalence, however, of each of these conditions in its isolated form (free of the other five) was 29.0% for obesity, 1.3% for Type 2 diabetes, 1.8% for impaired glucose tolerance, 1.5% for hypertension, 1.0% for hypertriglyceridaemia, and 1.7% for hypercholesterolaemia. Two-by-two associations were even rarer. The large differences in prevalence between isolated and mixed forms indicate a major overlap among the six disorders in multiple combinations. In the isolated form, each condition was characterized by hyperinsulinaemia (both fasting and 2 h after oral glucose), suggesting the presence of insulin resistance. In addition, in any isolated condition most of the variables categorising other members of the sextet were still significantly altered in comparison with 1,049 normal subjects. In the whole of the subjects who presented with one or another disorder (1,881 of 2,930 or 64%), marked fasting and post-glucose hyperinsulinaemia was associated with higher body mass index, waist:hip ratio, fasting and post-glucose glycaemia, systolic and diastolic blood pressure, serum triglycerides and total cholesterol levels, and with lower HDL-cholesterol concentrations (all p less than 0.001). We conclude that (1) insulin sensitivity, glucose tolerance, blood pressure, body fat mass and distribution, and serum lipids are a network of mutually interrelated functions; and (2) an insulin resistance syndrome underlies each and all of the six disorders carrying an increased risk of coronary artery disease.

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    • "Insulin resistance (IR) syndrome is one of the important risk factor for cardiovascular diseases[1] [2] [3] [4] [5] [6] [7]. The evaluation of the insulin resistance has received considerable attention in the last few years. "

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    • "The association between depression and CVD has been identified and the increased risk due to this psychological factor is of similar order to the more conventional CHD risk factors such as smoking, dyslipidaemia, and hypertension [1]. In addition, the constellation of risk factors known as metabolic syndrome has also been shown to be highly predictive of the development of CVD [2] [3]. Metabolic syndrome is defined by the International Diabetes Federation as central obesity plus two of the following: elevated triglycerides , reduced HDL-cholesterol, elevated blood pressure, and/or elevated fasting blood glucose [4]. "
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    ABSTRACT: This study examined the effects of Tai Chi, a low-impact mind-body movement therapy, on severity of depression, anxiety, and stress symptoms in centrally obese people with elevated depression symptoms. In total, 213 participants were randomized to a 24-week Tai Chi intervention program or a wait-list control group. Assessments were conducted at baseline and 12 and 24 weeks. Outcomes were severity of depression, anxiety, and stress symptoms, leg strength, central obesity, and other measures of metabolic symptom. There were statistically significant between-group differences in favor of the Tai Chi group in depression (mean difference = −5.6 units, í µí±ƒ < 0.001), anxiety (−2.3 units, í µí±ƒ < 0.01), and stress (−3.6 units, í µí±ƒ < 0.001) symptom scores and leg strength (1.1 units, í µí±ƒ < 0.001) at 12 weeks. These changes were further improved or maintained in the Tai Chi group relative to the control group during the second 12 weeks of follow-up. Tai Chi appears to be beneficial for reducing severity of depression, anxiety, and stress and leg strength in centrally obese people with depression symptoms. More studies with longer follow-up are needed to confirm the findings. This trial is registered with ACTRN12613000010796.
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    • "Insulin resistance (IR) is a metabolic disorder independently associated with cardiovascular disease [1] [2] [3]. IR is associated with aging and a cluster of important cardiometabolic risk factors (dyslipidemia, arterial hypertension, hyperglycemia, and obesity) and is believed to be the common shared pathophysiological disturbance [4] [5] [6] [7] [8]. "
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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).
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