The relationships between insulin resistance and components of metabolic syndrome in Taiwanese Asians

Dec 15, 2005International journal of clinical practice

How insulin resistance relates to parts of metabolic syndrome in Taiwanese Asians

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Abstract

In a study of 564 middle-aged healthy subjects, mean blood pressure and triglyceride levels in the group with the most severe insulin resistance were lower than current Metabolic Syndrome cutoffs.

Group 4, representing the top 25 percentile for insulin resistance, showed a mean fasting plasma glucose of 6.2 mmol/l.
Mean blood pressure values were 125/81 mmHg for males and 125/80 mmHg for females, both below the existing cutoff of 140/90 mmHg.
Triglyceride levels were 1.6 mmol/l for males and 1.4 mmol/l for females, lower than the current cutoff of 1.7 mmol/l for males.
High-density lipoprotein cholesterol and body mass index in Group 4 were consistent with existing definitions.
Proposals include lowering the blood pressure cutoff to 125/80 mmHg and triglyceride cutoffs to 1.6 mmol/l for males and 1.4 mmol/l for females.
Further larger-scale epidemiological studies are needed to validate these proposed cutoffs.

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Metabolic syndrome (MetS) is a complicated clinicopathological entity with clustering of cardiovascular and metabolic risk factors, which includes central obesity, hypertension, dyslipidemia and glucose intolerance. There were many studies investigating a wide variety of clinical and pathophysiological aspects of this syndrome. However, the cutoffs of the components of MetS are not yet being evaluated by measured the insulin resistance (IR) directly. In this study, we enrolled 564 (male/female: 250/314) middle-aged healthy subjects. Each of the male and the female group was further divided into four subgroups (group 1 to group 4). Group 4 had the top 25 percentile of most severe IR determined by insulin suppression test. We then obtain the mean values of each component of the MetS in group 4 and compared them with the definitions of World Health Organization, National Cholesterol Education Program Adult Treatment Panel III, European Study Group of Insulin Resistance and International Diabetes Federation. The means of the blood pressure (BP) (male, 125/81; female, 125/80 mmHg) and the triglyceride (TG) (male, 1.6; female, 1.4 mmol/l) in group 4 were lower, and the fasting plasma glucose (6.2 mmol/l) was higher than the cutoffs of the other four sets of the criteria. The means of the high-density lipoprotein cholesterol (male, 0.9; female, 1.03 mmol/l) and the body mass index (male, 26.9; female 26.1 kg/m(2)) in group 4 were consistent with the cutoffs of other four groups and also the Taiwan Health Department criteria. In conclusion, we suggest to lower the cutoffs of the BP from 140/90 to 125/80 mmHg, TG from 1.7 to 1.6 mmol/l for males and 1.4 mmol/l for females for MetS definition, at least in Taiwan. This may help to early detect subjects under high risk of future coronary heart disease and diabetes. Still, these newly proposed cutoffs need larger-scale epidemiological studies to confirm.

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The relationships between insulin resistance and components of metabolic syndrome in Taiwanese Asians

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