Discordance between insulin resistance and metabolic syndrome: features and associated cardiovascular risk in adults with normal glucose regulation

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dc.contributor.authorOnat, Altan
dc.contributor.authorHergenç, Gülay
dc.contributor.authorTürkmen, Serdar
dc.contributor.authorYazıcı, Mehmet
dc.contributor.authorSarı, İbrahim
dc.contributor.authorCan, Günay
dc.date.accessioned2020-05-01T09:11:26Z
dc.date.available2020-05-01T09:11:26Z
dc.date.issued2006
dc.departmentDÜ, Tıp Fakültesi, Cerrahi Tıp Bilimleri Bölümüen_US
dc.descriptionSari, Ibrahim/0000-0002-5545-8874;en_US
dc.descriptionWOS: 000236530000004en_US
dc.descriptionPubMed: 16546474en_US
dc.description.abstractThe aims of this study were to investigate the extent of concordance between metabolic syndrome (MS) and insulin resistance (IR), the features of discordance, and the magnitude of their independent association with cardiovascular disease (CVD) risk. After exclusion of individuals with diabetes and impaired fasting glucose, the population sample of 1534 men and women, representative of Turkish adults (mean age, 52.2 years), were evaluated cross-sectionally and at a mean 2 years' follow-Lip. Metabolic syndrome was identified by criteria of the Adult Treatment Panel III, except for male waist circumference (> 94 cm). Insulin resistance was defined by the upper quartile in the sample (> 2.245) of the homeostatic model assessment (HOMA) index. Clinical fatal and nonfatal CVD existed or developed in 165 subjects. Waist circumference proved to be by far the strongest significant determinant of HOMA in both sexes, followed by triglycerides. The cohort was categorized into 4 by the presence or absence of MS and IR. Each of the latter represented 34% and 25%, but together constituted 45% of the sample, thus disclosing concordance in a third of the conditions combined. The nonconcordant IR/NoMS group was less common than the MS/NoIR group and was distinct front the latter in having significantly lower waist girth, blood pressure, apolipoprotein B and triglyceride levels, and higher high-density lipoprotein cholesterol, glucose, and insulin levels and physical activity in both sexes. When adjusted for 5 important risk factors, although the excess risk in men with MS failed to attain significance, men with IR were associated with a significant 1.9-fold CVD risk. The IR/NoMS group had a 2.2-fold (95% confidence interval, 0.97-5.11) CVD likelihood compared with the large iusulin-sensitive group, after adjustment for age, sex, log C-reactive protein, low-density lipoprotein cholesterol, smoking status, physical activity, and the 2 groups of MS with or without IR. Overlapping between MS and IR is limited in either sex, and MS/NoIR is more common than IR/NoMS. Overall, IR is more significantly associated with CVD risk than MS in men and in both sexes after adjustment for important confounders. Insulin resistance without MS tends to implicate in middle-aged and elderly Turkish men roughly a 2-fold CVD risk, corresponding to 50% excess risk per 1 SD in HOMA index, independent of MS and important covariates. (c) 2006 Elsevier Inc. All rights reserved.en_US
dc.identifier.doi10.1016/j.metabol.2005.10.005en_US
dc.identifier.endpage452en_US
dc.identifier.issn0026-0495
dc.identifier.issn1532-8600
dc.identifier.issue4en_US
dc.identifier.startpage445en_US
dc.identifier.urihttps://doi.org/10.1016/j.metabol.2005.10.005
dc.identifier.urihttps://hdl.handle.net/20.500.12684/5590
dc.identifier.volume55en_US
dc.identifier.wosWOS:000236530000004en_US
dc.identifier.wosqualityQ2en_US
dc.indekslendigikaynakWeb of Scienceen_US
dc.indekslendigikaynakPubMeden_US
dc.language.isoenen_US
dc.publisherW B Saunders Co-Elsevier Incen_US
dc.relation.ispartofMetabolism-Clinical And Experimentalen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/closedAccessen_US
dc.titleDiscordance between insulin resistance and metabolic syndrome: features and associated cardiovascular risk in adults with normal glucose regulationen_US
dc.typeArticleen_US

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