title: Risk factor clustering in the insulin resistance syndrome and its relationship to cardiovascular disease in postmenopausal white, black, hispanic, and Asian/Pacific Islander women.
abstract: The aim of this study was to examine how major components of the insulin resistance (IR) syndrome relate to each other and to cardiovascular disease (CVD) in postmenopausal women in 4 ethnic groups. Baseline data from the Women's Health Initiative (WHI) on 3,083 50- to 79-year-old women (1,635 white, 802 black, 390 Hispanic, and 256 Asian/Pacific Islander) were examined. Participants underwent a personal interview and a physical examination, blood samples were drawn, and a detailed cardiovascular history was ascertained. Factor analysis was used to assess the clustering and interdependence of groups of CVD-related IR syndrome variables. Four factors were identified. An obesity factor included IR in all groups and had a significant association with CVD in white (P =.0001) and Hispanic (P =.0024) women. A dyslipidemia factor (high-density lipoprotein [HDL], triglycerides, and HDL2: total HDL ratio) also included insulin and IR and was significantly correlated with CVD in black (P=.0006) and Hispanic (P =.0217) women and had a borderline association in white women (P =.068). Total and low-density lipoprotein (LDL) cholesterol did not relate to CVD in any group. Blood pressure was related weakly to CVD in white women (P =.0434) and strongly in black women (P =.0095). Components of the IR syndrome appear to be associated with CVD in postmenopausal women, although the magnitude of these relationships differed by ethnicity.
authors.affiliation: MedStar Research Institute, Washington, DC, USA.
authors.forename: Barbara V
authors.initials: BV
authors.lastname: Howard
authors.forename: Michael H
authors.initials: MH
authors.lastname: Criqui
authors.forename: J David
authors.initials: JD
authors.lastname: Curb
authors.forename: Rebecca
authors.initials: R
authors.lastname: Rodabough
authors.forename: Monika M
authors.initials: MM
authors.lastname: Safford
authors.forename: Nanette
authors.initials: N
authors.lastname: Santoro
authors.forename: Alan C
authors.initials: AC
authors.lastname: Wilson
authors.forename: Judith
authors.initials: J
authors.lastname: Wylie-Rosett
mesh_terms: D001741:Black or African American; D000368:Aged; D001213:Asian; D001824:Body Constitution; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000209:etiology*; D005006:Ethnicity; D005260:Female; D006630:Hispanic or Latino; D006801:Humans; D006949:Hyperlipidemias / Q000150:complications / Q000208:ethnology; D008075:Lipoproteins, HDL / Q000097:blood; D053439:Lipoproteins, HDL2; D024821:Metabolic Syndrome / Q000150:complications / Q000208:ethnology*; D008875:Middle Aged; D009765:Obesity / Q000150:complications / Q000208:ethnology; D017698:Postmenopause; D014280:Triglycerides / Q000097:blood; D044465:White People; D016387:Women's Health
chemical_list: D008075:Lipoproteins, HDL; D053439:Lipoproteins, HDL2; D014280:Triglycerides