Hyperinsulinemia and insulin resistance are independently associated with plasma lipids, uric acid and blood pressure in non-diabetic subjects. The GISIR database.
OBJECTIVE
We evaluated whether hyperinsulinemia and/or insulin resistance are independently associated with plasma lipids, uric acid and blood pressure in non-diabetic subjects.


RESULTS
A database of non-diabetic Italian subjects has recently been set up using data from hyperinsulinemic euglycemic clamp studies carried out using the standard technique (40 mU per min per square meter of body surface area). In this database we evaluated the relationships between fasting plasma insulin (FPI), glucose metabolized during clamp (M) and plasma levels of triglycerides (TG), high density lipoprotein cholesterol (HDL-C), uric acid (UA) as well as blood pressure (BP) in non-diabetic subjects with fasting plasma glucose <6.1 mmol/l. Parallel analyses were conducted in all subjects in the database (n=1093) and in those with all variables available (n=309). In the univariate analysis both FPI and M were significantly correlated with TG, HDL-C, UA and BP (systolic, diastolic and mean). Multivariate regression analyses including center, sex, age, body mass index (BMI), FPI and M as independent variables showed that: (1) TG and UA were positively correlated with FPI and negatively correlated with M; (2) HDL-C was negatively correlated with FPI and positively correlated with M; and (3) BP was negatively correlated with both FPI and M. Analyses of covariance showed that, after adjusting for center, sex, age and BMI, subjects with isolated hyperinsulinemia or isolated insulin resistance had higher TG and UA and lower HDL-C. Subjects with isolated insulin resistance had also higher BP whereas subjects with isolated hyperinsulinemia had lower BP. Subjects with both defects had a worse profile.


CONCLUSIONS
Hyperinsulinemia and insulin resistance might contribute with distinct and independent mechanisms to the development of several metabolic and hemodynamic disorders often clustering in the same individual. In particular, hypertriglyceridemia, low HDL-cholesterol and hyperuricemia seem to be related to both hyperinsulinemia and insulin resistance, whereas hypertension seems to be related only to insulin resistance.
Bonora
Enzo
E
University of Verona, Verona, Italy. enzo.bonora@univr.it
Capaldo
Brunella
B
Perin
Paolo Cavallo
PC
Del Prato
Stefano
S
De Mattia
Giancarlo
G
Frittitta
Lucia
L
Frontoni
Simona
S
Leonetti
Frida
F
Luzi
Livio
L
Marchesini
Giulio
G
Marini
Maria Adelaide
MA
Natali
Andrea
A
Paolisso
Giuseppe
G
Piatti
Pier Marco
PM
Pujia
Arturo
A
Solini
Anna
A
Vettor
Roberto
R
Bonadonna
Riccardo C
RC
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001794:Blood Pressure; D008076:Cholesterol, HDL / Q000097:blood; D006801:Humans; D006946:Hyperinsulinism / Q000097:blood / Q000150:complications* / Q000503:physiopathology; D007333:Insulin Resistance; D008055:Lipids / Q000097:blood*; D008875:Middle Aged; D014280:Triglycerides / Q000097:blood; D014527:Uric Acid / Q000097:blood*
D008076:Cholesterol, HDL; D008055:Lipids; D014280:Triglycerides; D014527:Uric Acid