Serum insulin and inflammatory markers in overweight individuals with and without dyslipidemia.
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.
Barter
Philip
P
The Heart Research Institute, Camperdown, New South Wales, Australia. barterp@hri.org.au
McPherson
Y Ruth
YR
Song
Kijoung
K
Kesäniemi
Y Antero
YA
Mahley
Robert
R
Waeber
Gérard
G
Bersot
Thomas
T
Mooser
Vincent
V
Waterworth
Dawn
D
Grundy
Scott M
SM
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
D015415:Biomarkers; D001786:Blood Glucose; D008076:Cholesterol, HDL; D007328:Insulin; D014280:Triglycerides