Prevalence of Insulin Resistance Syndrome in Southwestern France and Its Relationship With Inflammatory and Hemostatic Markers

Abstract

OBJECTIVE -To assess the prevalence and relationships of insulin resistance syndrome (IRS) with inflammatory and hemostatic markers in a representative sample of the population of Southwestern France aged 35-64 years.RESEARCH DESIGN AND METHODS -In this cross-sectional study, data were collected from 597 men and 556 women and were assessed regarding BMI, blood pressure, total and HDL cholesterol levels, triglyceride level, glucose level, plasma insulin level, white blood cell count, fibrinogen level, factor VII level, von Willebrand factor, C-reactive protein level, soluble intercellular adhesion molecule, soluble vascular cell adhesion molecule-1, and soluble CD 14 . Insulin resistance was defined by homeostasis model assessment Ն3.8.RESULTS -Prevalence of IRS was higher in men than in women (23 vs. 12%, respectively; P Ͻ 0.001) and increased with age in both sexes (9, 24, and 34% for age groups 35-44, 45-54, and 55-64 years, respectively, for men and 4, 10, and 21% for women). After adjusting for age, alcohol consumption, tobacco smoking, and also for menopause in women, subjects (men and women) with IRS had significantly higher white blood cell count, factor VII levels, coagulating factor VII levels, and C-reactive protein levels than the other subjects. In men, further increases in soluble intercellular adhesion molecule and soluble vascular cell adhesion molecule-1 were noted, whereas in women, the differences were borderline significant. Conversely, no differences were found in fibrinogen, von Willebrand factor, and soluble CD 14 in both sexes.CONCLUSIONS -IRS is relatively common in residents of Southwestern France and is related to a deleterious increase in hemostatic and inflammatory parameters. Diabetes Care 25:1371-1377, 2002I nsulin resistance syndrome (IRS) is characterized by the clustering of several cardiovascular risk factors, such as increased insulin levels, hypertension, obesity, and dyslipidemia (1), and is related to an increased cardiovascular risk (2) and an increased incidence of coronary heart disease (3). Although the effects of IRS on atherosclerosis and coronary heart disease are believed to be exerted via the different risk factors that compose this clinical entity (4), less is known regarding the levels of inflammatory, hemostatic, and endothelial cell activation (5). Furthermore, although the prevalence of IRS has been assessed in several populations (6 -9), only very few studies have focused on its prevalence in France. Therefore, we used data from the third MONICA survey to assess the prevalence of IRS and the levels of inflammatory and hemostatic factors in patients of both sexes with IRS in Southwestern France, a region characterized by a low level of cardiovascular disease (10). RESEARCH DESIGN AND METHODS PopulationsThe World Health Organization MONICA Project is a study that monitors deaths due to coronary heart disease and myocardial infarction, coronary care, and risk factors in men and women aged 35-64 years (11). It consists of 39 MONICA Collaborative Centers in 26 coun...

Among inflammation and coagulation markers, PAI-1 is a true component of the metabolic syndrome

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