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Cited by 268Diabetes, Cardiovascular Risks, and LipoproteinsAdipokines, Inflammation, and Metabolic DiseasesCardiovascular Function and Risk Factors

Prevalence of insulin resistance and associated cardiovascular disease risk factors among normal weight, overweight, and obese individuals

McLaughlin, Tracey, Allison, Gregory, Abbasi, Fahim, Lamendola, Cindy, Reaven, Gerald·2004·Metabolism
DOI 10.1016/j.metabol.2003.10.032
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Abstract

Obese individuals tend to be both insulin resistant and at increased risk to develop cardiovascular disease (CVD). Given the increased prevalence of obesity in the US population, we thought it important to define the relationship between degree of obesity and insulin-mediated glucose disposal in the population at large, as well as the relationship between obesity, insulin resistance, and CVD risk in these individuals. To do this we quantified insulin-mediated glucose disposal in 465 healthy volunteers by determining the steady-state plasma glucose (SSPG) concentrations at the end of a 180-minute infusion of somatostatin, insulin, and glucose. Adiposity was estimated by body mass index (BMI) and the relationship between BMI and SSPG defined. In addition, a series of CVD risk factors were measured, including blood pressure, plasma glucose, and insulin concentrations, before and after 75 g of oral glucose, and fasting plasma lipid and lipoprotein concentrations. The results indicated that SSPG concentration and BMI were significantly correlated (r = 0.54, P >.001), and 36% of individuals in the most insulin-resistant tertile were obese (BMI >/= 30.0 kg/m(2)). However, 16% of those in the most insulin-resistant tertile were of normal weight (BMI < 25.0 kg/m(2)). Although CVD risk factors were accentuated in general with progressive increases in either BMI or SSPG concentration, important differences were noted. Thus, the higher the SSPG concentration, the more the increase in plasma glucose, insulin, and triglyceride (TG) concentrations, whereas the greater the BMI, the higher the low-density lipoprotein concentration. Furthermore, while CVD risk factors increased significantly with each tertile of insulin resistance, significant differences in CVD risk were only apparent when the lowest BMI tertile was compared with the other 2, with the values in the middle and upper BMI differing from each other. These results show that while BMI and insulin resistance are related, they are not synonymous, and that they make independent and different contributions to increasing CVD risk.

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  • The US population varies considerably in degree of insulin resistance; those with more inherent insulin resistance can develop the metabolic syndrome with only moderate excess abdominal fat, while even people with little or no inherent insulin resistance can develop it if they accumulate marked abdominal obesity.

    “Moreover, the population of the United States varies considerably in degree of insulin resistance 46 ; those having more inherent insulin resistance can develop the metabolic syndrome with only moderate excess in abdominal fat, 43,44 but even people with little or no inherent insulin resistance can develop the metabolic syndrome if they accumulate marked abdominal obesity.3,8”

    From Diagnosis and Management of the Metabolic Syndrome: An American Heart Association/National Heart, Lung, and Blood Institute Scientific Statement (2005) · cites this paper as [46]

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Authors
McLaughlin, T., Allison, G., Abbasi, F., Lamendola, C., & Reaven, G.
Affiliations
Stanford Medicine (US)
ORCID
Venue
Metabolism
Publisher
Elsevier BV
Published
2004-04
Volume
53
Issue
4
Pages
495-499
ISSN
0026-0495 (ISSN-L)
DOI
10.1016/j.metabol.2003.10.032
OpenAlex
W1983287346
Cited by
268
References
31
Citations by year
2026: 4 · 2025: 7 · 2024: 8 · 2023: 6 · 2022: 15 · 2021: 13 · 2020: 10 · 2019: 3 · 2018: 12 · 2017: 7 · 2016: 12 · 2015: 19 · 2014: 12 · 2013: 13 · 2012: 10
FWCI
12.40
Type
journal article
Language
en
Open access
closed
Licence
Locations
  • Metabolism (publishedVersion)
  • PubMed (publishedVersion)
Funders
National Center for Research Resources (K23RR016071, RR 00 070, M01RR000070, RR-16071)
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
  • Health Sciences › Medicine › Epidemiology › Adipokines, Inflammation, and Metabolic Diseases
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Function and Risk Factors
Keywords
insulin resistance, obesity, cardiovascular risk factors, body mass index, steady-state plasma glucose, insulin-stimulated glucose disposal, triglycerides, low-density lipoprotein, blood pressure, plasma lipids, overweight
MeSH terms
Analysis of Variance, Blood Glucose, Blood Pressure, Body Weight, Cardiovascular Diseases, Female, Humans, Insulin Resistance, Cholesterol, HDL, Cholesterol, LDL, Male, Middle Aged, Obesity, Regression Analysis, Risk Factors, Triglycerides, Body Mass Index, Prevalence

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