title: Serum insulin and inflammatory markers in overweight individuals with and without dyslipidemia.
abstract: BACKGROUND
  The worldwide epidemic of overweight and obesity is setting the scene for a new wave of premature cardiovascular disease.
  
  
  OBJECTIVE
  The objective of this study was to define relationships between dyslipidemia and other metabolic abnormalities in overweight subjects.
  
  
  METHODS
  This study included comparison of overweight subjects with and without dyslipidemia.
  
  
  METHODS
  The setting was an institutional practice.
  
  
  METHODS
  Dyslipidemic subjects (n = 715) had plasma triglyceride greater than or equal to the 75th percentile in combination with high-density lipoprotein cholesterol (HDL-C) less than or equal to the 25th percentile. Unrelated, normolipidemic controls (n = 1073) had HDL-C higher than the median and triglyceride lower than the median. It was a requirement for the control subjects to have a body mass index (BMI) greater than 25 kg/m(2).
  
  
  METHODS
  The main outcome measures included BMI, inflammatory markers, adipokines, blood pressure, and fasting plasma glucose and insulin.
  
  
  RESULTS
  The mean BMI in the subjects and controls was 28.7 and 28.2 kg/m(2), respectively. Subjects had higher levels of plasma high-sensitivity C-reactive protein (3.0 vs. 2.0 mg/liter; P < 0.001), lower levels of adiponectin (4.7 vs. 6.6 mg/liter; P < 0.001), and, after adjustment for age, BMI, gender, smoking, statin, and beta-blocker use, higher systolic (P = 0.001) and diastolic (P = 0.05) blood pressures. Fasting plasma glucose, insulin, and homeostasis model of assessment-insulin resistance were all significantly higher in subjects than controls (P < 0.0001).
  
  
  CONCLUSIONS
  Identification of people solely on the basis of an elevated plasma triglyceride and a low HDL-C uncovers an overweight group of people who have a generalized metabolic disorder. In contrast, overweight people with normal plasma lipids have normal glucose and insulin metabolism, low levels of inflammatory markers, and normal blood pressure. Such people may thus be at relatively low risk of developing diabetes and cardiovascular disease despite being overweight.
authors: The Heart Research Institute, Camperdown, New South Wales, Australia. barterp@hri.org.au
authors: Philip
authors: P
authors: Barter
authors: Y Ruth
authors: YR
authors: McPherson
authors: Kijoung
authors: K
authors: Song
authors: Y Antero
authors: YA
authors: Kesäniemi
authors: Robert
authors: R
authors: Mahley
authors: Gérard
authors: G
authors: Waeber
authors: Thomas
authors: T
authors: Bersot
authors: Vincent
authors: V
authors: Mooser
authors: Dawn
authors: D
authors: Waterworth
authors: Scott M
authors: SM
authors: Grundy
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000378:metabolism; D001794:Blood Pressure; D015992:Body Mass Index; D008076:Cholesterol, HDL / Q000097:blood; D050171:Dyslipidemias / Q000453:epidemiology / Q000276:immunology* / Q000378:metabolism*; D005260:Female; D006801:Humans; D007328:Insulin / Q000097:blood*; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology / Q000276:immunology* / Q000378:metabolism*; D012307:Risk Factors; D014280:Triglycerides / Q000097:blood
chemical_list: D015415:Biomarkers; D001786:Blood Glucose; D008076:Cholesterol, HDL; D007328:Insulin; D014280:Triglycerides