Relationship between obesity, insulin resistance, and coronary heart disease risk.
OBJECTIVE
The study goals were to: 1) define the relationship between body mass index (BMI) and insulin resistance in 314 nondiabetic, normotensive, healthy volunteers; and 2) determine the relationship between each of these two variables and coronary heart disease (CHD) risk factors.


BACKGROUND
The importance of obesity as a risk factor for type 2 diabetes and hypertension is well-recognized, but its role as a CHD risk factor in nondiabetic, normotensive individuals is less well established.


METHODS
Insulin resistance was quantified by determining the steady-state plasma glucose (SSPG) concentration during the last 30 min of a 180-min infusion of octreotide, glucose, and insulin. In addition, nine CHD risk factors: age, systolic blood pressure, diastolic blood pressure (DBP), total cholesterol, triglycerides (TG), high-density lipoprotein (HDL) cholesterol and low-density lipoprotein cholesterol concentrations, and glucose and insulin responses to a 75-g oral glucose load were measured in the volunteers.


RESULTS
The BMI and the SSPG concentration were significantly related (r = 0.465, p < 0.001). The BMI and SSPG were both independently associated with each of the nine risk factors. In multiple regression analysis, SSPG concentration added modest to substantial power to BMI with regard to the prediction of DBP, HDL cholesterol and TG concentrations, and the glucose and insulin responses.


CONCLUSIONS
Obesity and insulin resistance are both powerful predictors of CHD risk, and insulin resistance at any given degree of obesity accentuates the risk of CHD and type 2 diabetes.
Abbasi
Fahim
F
Department of Medicine, Stanford, California, USA
Brown
Byron William
BW
Lamendola
Cindy
C
McLaughlin
Tracey
T
Reaven
Gerald M
GM
D000328:Adult; D000367:Age Factors; D000368:Aged; D001786:Blood Glucose / Q000032:analysis; D001794:Blood Pressure; D015992:Body Mass Index; D008078:Cholesterol, LDL / Q000097:blood; D003327:Coronary Disease / Q000209:etiology*; D003922:Diabetes Mellitus, Type 1 / Q000209:etiology; D005260:Female; D005951:Glucose Tolerance Test; D006801:Humans; D007333:Insulin Resistance / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications*; D012307:Risk Factors; D014280:Triglycerides / Q000097:blood
D001786:Blood Glucose; D008078:Cholesterol, LDL; D014280:Triglycerides