Influence of insulin resistance, secretion, and clearance on serum cholesterol, triglycerides, lipoprotein cholesterol, and blood pressure in healthy men.

Godsland, Ian F.; Crook, David; Walton, Christopher; Wynn, V.; Oliver, M.F.

doi:10.1161/01.atv.12.9.1030

Cited by 46 publications

(22 citation statements)

References 45 publications

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“…Blades et al [45] have reported that a high hepatic li-pase activity is associated with low HDL but normal VLDL levels. In addition, there is evidence to suggest that insulin resistance may influence the activity of both lipoprotein and hepatic lipase enzymes [46,47]. In support of this, we have observed a decrease in lipoprotein lipase/hepatic lipase ratio in insulin-resistant males [48].…”

Section: Discussionsupporting

confidence: 76%

Insulin resistance and abnormal albumin excretion in non-diabetic first-degree relatives of patients with NIDDM

et al. 1995

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SummaryMicroalbuminuria has recently been associated with insulin resistance in both insulin-dependent and non-insulin-dependent (NIDDM) diabetes mellitus. To establish whether microalbuminuria in non-diabetic subjects as well is associated with insulin resistance and associated abnormalities in glucose and lipid metabolism, oral glucose tolerance tests were performed with measurement of urinary albumin excretion rate, lipids and lipoproteins in 582 male non-diabetic first-degree relatives of patients with NIDDM. In addition, insulin sensitivity was assessed in 20 of these subjects with the euglycaemic hyperinsulinaemic clamp technique. Abnormal albumin excretion rate (AER), defined as AER 15-200 ~tg/min, was associated with higher systolic blood pressure (p < 0.05), higher fasting glucose values (p < 0.05), lower HDL-cholesterol (p < 0.05) and lower apolipoprotein A-I (p < 0.05) concentrations than observed in subjects with normal AER. The rate of glucose metabolism was lower in subjects with abnormal compared to subjects with normal albumin excretion rate (38.0 + 2.8 vs 47.3 + 2.4 ~tmol -kg lean body mass-a min-1; p = 0.028). This difference was almost completely accounted for by a reduction in non-oxidative glucose metabolism (17.7+1.9 vs 27.4+2.7 ~tmol. kg lean body mass -1 min-1; p = 0.010), which correlated inversely with the AER (r = -0.543; p = 0.013). These results suggest that in non-diabetic individuals genetically predisposed to NIDDM, abnormal AER is associated with insulin resistance and abnormalities in glucose and lipid metabolism. [Diabetologia (1995) 38:363 -369] Key words Microalbuminuria, insulin resistance syndrome, insulin sensitivity, euglycaemic hyperinsulinaemic clamp.Microalbuminuria (urinary albumin excretion rate 20-200 ~tg/min) is a strong independent predictor of cardiovascular morbidity and mortality in diabetic and non-diabetic subjects [1][2][3][4][5][6][7][8]. Although the link between microalbuminuria and cardiovascular disease is unknown, insulin resistance has emerged as a common denominator [9][10][11][12][13]. In patients with both insu-

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Section: Discussionsupporting

confidence: 76%

Insulin resistance and abnormal albumin excretion in non-diabetic first-degree relatives of patients with NIDDM

et al. 1995

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“…27,28 Although the positive association between IR and a high BP has been reported to be independent of obesity in some studies, 26,29 other studies have suggested that obesity, in particular central obesity, may be the cause of this association. 24,28,30,31 However, the present study showed that the level of IR, BMI and waist circumference were independent risk factors of a high BP in normoglycemic Koreans.…”

Section: Discussioncontrasting

confidence: 62%

In Normoglycemic Koreans, Insulin Resistance and Adipocity are Independently Correlated With High Blood Pressure

Sung

Kim

et al. 2004

Circ J

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yperinsulinemia is known to be associated with various cardiovascular risk factors, including high triglyceride concentrations, low high-density lipoprotein (HDL) cholesterol concentrations, high blood pressure (BP), and obesity. 1-3 However, there is some controversy about the role of insulin resistance (IR) in the regulation of BP. Several prospective studies have linked insulin concentrations to the incidence of hypertension [4][5][6] and it has been suggested that hyperinsulinemia and/or IR plays a role in the pathophysiology of hypertension. [7][8][9][10][11] But the association between insulin and hypertension remains contentious, 12 with a number of studies reporting no association between insulin and BP. 13,14 Moreover, to our knowledge a large study of the association between BP and IR has not been conducted in normal glucose tolerance Asians. Therefore, we decided to investigate the relationships between BP and IR using a homeostasis model (HOMA-IR) and further, to evaluate the association between body fat distribution and high BP in nondiabetic normoglycemic Koreans. Methods Subjects and MeasurementsThe total number of subjects involved was 53,477, all of whom presented for a routine health status check up at the Kangbook Samsung Hospital, College of Medicine in Sungkyunkwan University in 2002, and who were without specific medical complaints. Based on the results obtained, patients suspected of having acute inflammatory diseases, other malignancies and those taking BP-lowering medication were excluded. In addition we also excluded those taking antidiabetic agents and those with a fasting glucose over 110 mg/dl. Finally, 49,076 subjects (31,820 men; 17,256 women) were included in this study. Anthropometric indices of adiposity, metabolic variables (including fasting serum insulin and homeostasis model assessment (HOMA) index of insulin sensitivity), BP and several cardiovascular risk factors were measured. The BP was determined using a mercury manometer, between 08.00 h and 10.00 h, after the subject had been sitting upright for at least 10 min.When the systolic or diastolic BP exceeded 140 mmHg or 90 mmHg, it was re-measured twice after a rest and averaged. A high BP was defined as a SBP ≥140 mmHg or a DBP ≥90 mmHg.The body mass index (BMI: kg/m 2 ), the waist circumference and the waist -hip ratio were also measured. The subjects were asked questions concerning the risk factors for general cardiovascular disease (ie, past medical history, life style, such as alcohol consumption, smoking, and Background There is some controversy about the role of insulin resistance (IR) in the regulation of blood pressure (BP). Moreover, a large study of the association between BP and IR has not been conducted in normal glucose tolerance Asians. The present study investigated the relationships between IR, body mass index (BMI) and waist circumference and BP in normoglycemic Koreans. Methods and ResultsAnthropometric indices of adiposity, metabolic variables (fasting serum insulin and a homeostasis model assessment (H...

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“…A relatively weak univariate correlation between insulin-related variables and HDL cholesterol was also seen in an analysis of data acquired more recently during the course of the HDDRISC study. 3 However, this data also included measurement of HDL 2 subfraction cholesterol, which showed a stronger correlation with insulin-related variables than did total HDL cholesterol. It is therefore possible that factor associations between HDL-and insulin-related measures might have been apparent in the HDDRISC-1 participants had HDL 2 subfraction measurements been available.…”

Section: Discussionmentioning

confidence: 99%

“…[3][4][5] It has been proposed that such intercorrelations indicate a distinct metabolic syndrome in which insulin resistance may have a central role. [6][7][8] Such a syndrome could include impaired glucose tolerance, hyperinsulinemia, high blood pressure, hypertriglyceridemia and low HDL concentrations, increased levels of the antifibrinolytic factor plasminogen activator inhibitor-1, increased levels of the atherogenic small, dense LDL, hyperuricemia, postprandial hyperlipidemia, and central obesity.…”

mentioning

confidence: 99%

Factors of the Metabolic Syndrome

Leyva

Godsland

Worthington

et al. 1998

ATVB

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Abstract-Syndromes of risk factor disturbance may contribute to the development of coronary heart disease and non-insulindependent diabetes mellitus, but their definition and quantification remain problematic. Using factor analysis, constellations of risk factor variables that could indicate distinct syndromes of metabolic disturbance were explored in the baseline data of the first follow-up cohort of 742 men from the Heart Disease and Diabetes Risk Indicators in a Screened Cohort (HDDRISC) study. The primary analysis considered 16 intercorrelated variables measured in more than 90% of cohort participants. A missing-values estimation routine was used to ensure inclusion of all participants in the analysis. Subanalyses were undertaken, including a repeat of the primary analysis on the 522 individuals who had received measurement of HDL cholesterol, an oblique rather than orthogonal factor rotation procedure performed on primary and HDL subset analyses, a repeat of these two primary and HDL subset analyses using only those participants with complete measurements, and a repeat of these six analyses including only the seven variables conventionally associated with the metabolic syndrome. The principal factor that emerged in all analyses undertaken comprised oral glucose tolerance test insulin and glucose response, serum uric acid, and body mass index. Fasting serum triglyceride concentration was included in this factor in 11 of the 12 analyses undertaken, fasting plasma insulin in 8, fasting plasma glucose in 5, and mean arterial pressure in 3. HDL cholesterol factored in isolation from insulin in all analyses undertaken. These findings provide strong support for a core metabolic cluster, which is unlikely to include blood pressure and does not include HDL. The factor scores relating to this cluster will provide a means of assessing its quantitative importance in prospective analysis of the development of CHD and diabetes in this cohort. (Arterioscler Thromb Vasc Biol. 1998;18:208-214.)Key Words: factor analysis Ⅲ metabolic syndrome Ⅲ cohort study Ⅲ insulin Ⅲ high density lipoprotein C oronary heart disease and diabetes mellitus share many risk factors in common, 1,2 and disturbances in these risk factors are themselves highly intercorrelated.3-5 It has been proposed that such intercorrelations indicate a distinct metabolic syndrome in which insulin resistance may have a central role. 6-8Such a syndrome could include impaired glucose tolerance, hyperinsulinemia, high blood pressure, hypertriglyceridemia and low HDL concentrations, increased levels of the antifibrinolytic factor plasminogen activator inhibitor-1, increased levels of the atherogenic small, dense LDL, hyperuricemia, postprandial hyperlipidemia, and central obesity.9 Mechanistic links can be proposed to explain these relationships and support the existence of a distinct metabolic syndrome.As yet, there appears to have been little attempt to quantify the metabolic syndrome or its clinical significance or even to determine to what extent it can be disting...

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Influence of insulin resistance, secretion, and clearance on serum cholesterol, triglycerides, lipoprotein cholesterol, and blood pressure in healthy men.

Cited by 46 publications

References 45 publications

Insulin resistance and abnormal albumin excretion in non-diabetic first-degree relatives of patients with NIDDM

Insulin resistance and abnormal albumin excretion in non-diabetic first-degree relatives of patients with NIDDM

In Normoglycemic Koreans, Insulin Resistance and Adipocity are Independently Correlated With High Blood Pressure

Factors of the Metabolic Syndrome

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