Obesity worsens cardiovascular risk profiles independently of hyperinsulinaemia

Abstract

Objective. To investigate whether human obesity is characterized by a worse cardiovascular risk profile (than no obesity) even in the absence of hyperinsulinaemia. Subjects and design. A total of 367 healthy subjects (247 nonobese and 120 obese) with normal glucose tolerance and without family history of diabetes mellitus. Interventions. A 75-g oral glucose tolerance test was performed in all participants. Main outcome measures. Anthropometry, blood pressure, fasting plasma lipids and urate, plasma glucose and insulin concentrations at fasting, 1 h and 2 h after oral glucose load. Results. In a multivariate linear regression analysis, body mass index was strongly related to all cardiovascular risk factors, independently of sex, age and plasma insulin. When risk factors were compared in 37 normoinsulinaemic obese subjects (plasma insulin within one standard deviation of the mean values observed in the 247 nonobese subjects), and in 3 7 sex-and age-matched normoinsulinaemic nonobese subjects, we found that plasma glucose levels were similar in the two groups, whereas plasma triglyceride (1.50+0.13 vs. 1.13f0.08 mmol L-': mean 4 SE). lowdensity lipoprotein cholesterol (3.4240.25 vs. 2.77f0.18 mmolL-') and urate (290f12 vs. 2 5 5 f 1 2 pmolL-') levels were significantly higher, and plasma highdensity lipoprotein cholesterol concentrations were lower (1.27k0.04 vs. 1.46f0.06 mmol L-' ) in obese than in nonobese subjects with normal plasma insulin levels (P c 0.01). Also systolic (132 f 2 vs. 2 4 f 2 mmHg)and diastolic ( 8 6 f l vs. 81 f 1 mmHg) blood pressure values were significantly higher in normoinsulinaemic obese subjects than in normoinsulinaemic nonobese individuals (P c 0.001).Conclusions. These results suggest that in human obesity a worse cardiovascular risk profile is found (than in the nonobese) independently of the presence of hyperinsulinaemia.

Resistance exercise and aerobic exercise when paired with dietary energy restriction both reduce the clinical components of metabolic syndrome in previously physically inactive males

“…Excess body fat has been linked to a variety of medical disorders including hypertension, hyperlipidemia, coronary artery disease, insulin resistance, and diabetes mellitus (Barret-Connor, 1985;Blair and Brodney, 1999;Bonora et al 1997;Faloia et al 2000;Gillum et al 1998;Goran and Gower, 1998). Furthermore, abdominal obesity has been speciWcally linked to the development of Type 2 diabetes mellitus (Bjorntorp, 1988;Després, 1993;Pouliot et al 1992), elevated blood lipid levels (DiPietro et al 1999;Pouliot et al 1992) and heart disease (Lamarche 1998).…”

Antidiabetic medications in overweight/obese patients with type 2 diabetes: drawbacks of current drugs and potential advantages of incretin-based treatment on body weight

“…Excess fat is associated with hypertension and dyslipidaemia, particularly when it accumulates in the central part of the body and the visceral area (16–18). Consequently, diabetes, obesity, dyslipidaemia and hypertension frequently occur in the same individual.…”