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Relation between body fat distribution and insulin-resistance in women with and without obesity
Thursday 27 May 1999 Poster session: The metabolic syndrome
60
insulin (-0.40; p = 0.0l), glucose (-0.43; p = 0.006), waist circumference [W] (-0.35; p = 0.30), waist-to-hip ratio [W/H] (-0.33; p = 0.38) and VAT (-0.41; p = 0.01). After adjusting for age, body mass index and physical activity, W and W/H ratio lost their significance and dietary fiber became statistically correlated with LDLps (0.33; p = 044). The DMHT group had a positive correlation with HDL-C (0.43; p = 0,001), apolipoprotein A-I (0.30; p = 0.23), and a negative association with LnTG (-0.44; p = 0.001 ). Multiple regression analysis showed that in the NDMHT group LnTG and insulin explained 45.5 and 6.5% of LDLps variation, respectively. In the DMHT group HDL-C explained 19.2% of LDLps variation. In conclusion, DMHT PMW have significantly smaller LDLps and a greater prevalence of pattern B. VAT is not independently associated to LDLps. OBESITY AND INSULIN RESISTANCE INFLUENCES A T H E R O G E N I C INDEX IN HEALTHY SUBJECTS
used the homeostasis model assessment (HOMA). Android distribution of fat was considered when the waist/hip ratio was >0.85. Comparing both groups, we found significant differences in systolic blood pressure (123.8+ 12 versus 147.5+27 mmHg, p < 0.001) and diastolic blood pressure 179.2-t-II versus 88.6+16 mmHg, p < 0.05), HDLc (56.2+11 versus 49.85:9 mg/dl, p < 0.05), fibrinogen 1271.5+48 versus 94.5+10 mg/dl, p < 0.05), insulin (7.6 5:3 versus 10.8+4 ~.tU/ml, p < 0.01 ) and insulin-resistance 11.8+0.8 versus 2.6-t-1, p < 0.001). According to the waist/hip ratio, we found significant differences in: Obc.sewomen:
W/H < 0.85 W/H > 0.85
Glucose(mg/dl)
Insulin()tU/ml)
Insulin-resistance
89:t:8 984-10
8.84-3 12.6±4
24-08 3.14-1
H. Rosolovh, J. Simon, O. Mayer jr.. Center of preventive medicine, W/HH > 0.85;
Charles UniversiO, Pilsen, Czech Republic Background: There is a well known association between obesity and insulin
resistance (IR) which is characterised by typical dyslipidemia i.e. Phenotype B (high triglyeerides-TG, and low HDL.-chol). There has not yet been unequivocally proved whether it is connected with higher atherogenic index (AI) given as high TG and apolipoprotein B (apo-B). Aim: To assess AI in healthy subjects with IR according to their obesity index. Methods: In 100 healthy subjects selected from the Pilsen population the IR was estimated by insulin suppression test using Octreotide. Steady state of plasma glucose (SSPG) in mmol/1 reflects the level of insulin-mediated glucose uptake. Obesity was measured by body mass index (BMI kg/m 2) and waist to hip ratio (WHR), immunoreactive insulin (IRI) level was tested by radioimmunoassay and lipid variables by standard kits. Statistical evaluation was done by Kruskall Wall)s" test-ANOVA. Results: Are given on the Table:
Risk |l¢lor
Age (yeats) WHR SSPG (retool/l) FastingIRI (mU/l) Tot..chollramoFI) LDL-chollmmot/1) HDL.-chol(mmolfl) TG (retool/l) apo-A (retool/l) apo-B (retool/l)
BMI (k~m 2 ) <26
26-30
>30
p
50.4 (9.0) 0.86 (0.12) 7.60 (3.51) 10.37110.04) 5.64 (1.01) 3.09 11.13) 1.59(0.48) 1.34 (0.84) 1.54 (0.33) 1,09 (0.26)
53.9 (10.8) 0.92 10.15) 8.95 (3.88) 10.8616.14) 5.42 (0.84) 3.11 (0.78) 1.20 (0.31) 1.79(I.07) 1.37 (0.21) 1.13 (0.26)
529 ( I I. I ) 0.92 10.10) 10.45 (3.65) 15.44 (8.721 5.82 (1.05) 3.52 (0.76) 1.21 (0.33) 2.55 12.15) 1.32 (0.26) 1.47 (1.271
NS
"" NS NS ""° °°" ""
"p < 0.05. "'p < 0.01, " " p < 0.001 BMI is in positive association with WHR, SSPG, fasting IR1, fasting TG and apo-B, in negative association with HDL--chol and apo A. AI defined as TG > 1.85 and apoB > 1.21 (the 3rd tertile of these variables) was found in 19 subjects (20%) out o f which 11 had BMI > 30. Obesity elevates the presence o f A l 3 times (OR = 3.08, 95% conf. limits 1.03-9.18). Conclusion: Obesity is associated not only with insulin resistance dyslipidemia pattern (Phenotype B) but also with higher apo-B which may contribute to high atherogenic risk. RELATION B E T W E E N BODY FAT DISTRIBUTION AND INSULIN° RESISTANCE IN W O M E N W I T H AND W I T H O U T OBESITY A. Hernhndez, I. Lluch, C. Morillas, R. Royo, C. Meli~i, E. S o l i M.L. Mufioz, H. Pefia, M. G6mez. Endocrinology Department. Dr. Peset
Hospital Valencia, Spain Android distribution of fat is related to plurimetabolic syndrome and increases the cardiovascular risk, although this association is less defined in women than in men. The aim o f this study is to evaluate the relation between android distribution of fat and insulin-resistance in a group of obese and non-obese women. Eighty six women were studied: 35 non-obese (mean age: 44.1+18.2 years, BMI: 22.9-1-2.6 Kg/m 2) and 51 with obesity (mean age: 48.7+13. I years, BMI: 32.7+3.4 Kg/m2). We measured: lipidic profile, fibrinogen, basal glucose and insulin. To evaluate basal insulin-resistance, we
Systolic BP HDLc (mg/dl)
Apo A (mg/dl)
(.ilycemia Insulin (mg/dl) (llUiml)
IR
1234-9 1504-3
1574-22 1404-18
914-11 98±10
I 6±08 31~1
(mmHg)
Normal Obese
604-13 484-7
7.34-3 12.64-4
Conclusions: 1. In women, obesity is related with hypertension, decrease in HDLc, hyperfibrinogenemia and insulin-resistance. 2. Android obesity, is related with more insulin-resistance. 3. The android distribution of fat in obesity, is characterised by more insulinresistance, a decrease in HDLc and diastolic hypertension.
C O R R E L A T I O N A M O N G M E T A B O L I C PROFILE, BLOOD PRESSURE AND ADIPOSE TISSUE IN EXTREMELY OBESE WOMEN E. Stoki(3, T. Ivkovit-Lazar, A. Stoki~ 1, Lj. Lep,~anovi62, L. Lep~;anovi~.
IDept. of Endocrinologl; Dept. of OncoloKv" 2Dept. of PathophysioloKv: Medical Faculty Noui Sad. }itgoslauia We examined a group of 80 obese females (BMh 38.65 +/- 6.35 ktym 2, 40 with android (WHR: 1.16 +/- 0.04) and 40 with gynoid type (WHR: 0.81 +/- 0.01)) in whom, apart from standard measures (body weight, height, body mass index, waist-to-hip ratio), the adipose tissue depots were measured by ultrasonography. In order to study glycoregulation, all obese women passed OGTT with determination of insulinemia. Regarding lipid parameters, total, HDL-, LDL-and VLDL- cholesterol, triglycerides and index of atherosclerosis were determined. Results showed a statistically significant higher visceral adipose tissue in females with android type of obesity comparing the gynoid (28.39 +/10.22 mm vs. 22.88 +/- 226 mm, p < 0.05), but subcutaneous fat tissue was statistically significant higher in the gynoid group (31.29 +/- 6.14 mm vs. 20.79 +/- 8.95, p < 0.001). The values of insulinemia were significantly higher in the android than in the gynoid group in all times during the OGTT (p < 0.01). The hyperinsulinemia was recorded and followed by higher values of total cholesterol (618 + / - 0.77 vs 5 1 8 + / - 0.65 retool/l, p < 0.05), triglycerides (2.75 + / - 0.96 vs. 1.30 + l - 0.43 mmol/I, p < 0.05), LDL..cholesterol (4.51 +/- 0.33 vs. 3.78 +/- 1.64 retool/l, p < 0.05) and lower values of HDL-cholesterol (0.88 +/- .29 vs. 1.14 +/- 0.37 retool/I, p < 0.01) in the android than in the gynoid group, higher values of systolic and diastolic blood pressure in the android than in the gynoid group. Also, our results, in the group of android obese women, showed that there was a significant association among values o f visceral adipose tissue and lipid disorders, hypeinsulinism and higher values of systolic and diastolic blood pressure. Our results suggest that the ultrasound measuring could be used as a very valuable parameter in order to distinguish the obese persons with the risky metabolic profile.
71st EAS.Congress and Satellite Symposia
60
insulin (-0.40; p = 0.0l), glucose (-0.43; p = 0.006), waist circumference [W] (-0.35; p = 0.30), waist-to-hip ratio [W/H] (-0.33; p = 0.38) and VAT (-0.41; p = 0.01). After adjusting for age, body mass index and physical activity, W and W/H ratio lost their significance and dietary fiber became statistically correlated with LDLps (0.33; p = 044). The DMHT group had a positive correlation with HDL-C (0.43; p = 0,001), apolipoprotein A-I (0.30; p = 0.23), and a negative association with LnTG (-0.44; p = 0.001 ). Multiple regression analysis showed that in the NDMHT group LnTG and insulin explained 45.5 and 6.5% of LDLps variation, respectively. In the DMHT group HDL-C explained 19.2% of LDLps variation. In conclusion, DMHT PMW have significantly smaller LDLps and a greater prevalence of pattern B. VAT is not independently associated to LDLps. OBESITY AND INSULIN RESISTANCE INFLUENCES A T H E R O G E N I C INDEX IN HEALTHY SUBJECTS
used the homeostasis model assessment (HOMA). Android distribution of fat was considered when the waist/hip ratio was >0.85. Comparing both groups, we found significant differences in systolic blood pressure (123.8+ 12 versus 147.5+27 mmHg, p < 0.001) and diastolic blood pressure 179.2-t-II versus 88.6+16 mmHg, p < 0.05), HDLc (56.2+11 versus 49.85:9 mg/dl, p < 0.05), fibrinogen 1271.5+48 versus 94.5+10 mg/dl, p < 0.05), insulin (7.6 5:3 versus 10.8+4 ~.tU/ml, p < 0.01 ) and insulin-resistance 11.8+0.8 versus 2.6-t-1, p < 0.001). According to the waist/hip ratio, we found significant differences in: Obc.sewomen:
W/H < 0.85 W/H > 0.85
Glucose(mg/dl)
Insulin()tU/ml)
Insulin-resistance
89:t:8 984-10
8.84-3 12.6±4
24-08 3.14-1
H. Rosolovh, J. Simon, O. Mayer jr.. Center of preventive medicine, W/HH > 0.85;
Charles UniversiO, Pilsen, Czech Republic Background: There is a well known association between obesity and insulin
resistance (IR) which is characterised by typical dyslipidemia i.e. Phenotype B (high triglyeerides-TG, and low HDL.-chol). There has not yet been unequivocally proved whether it is connected with higher atherogenic index (AI) given as high TG and apolipoprotein B (apo-B). Aim: To assess AI in healthy subjects with IR according to their obesity index. Methods: In 100 healthy subjects selected from the Pilsen population the IR was estimated by insulin suppression test using Octreotide. Steady state of plasma glucose (SSPG) in mmol/1 reflects the level of insulin-mediated glucose uptake. Obesity was measured by body mass index (BMI kg/m 2) and waist to hip ratio (WHR), immunoreactive insulin (IRI) level was tested by radioimmunoassay and lipid variables by standard kits. Statistical evaluation was done by Kruskall Wall)s" test-ANOVA. Results: Are given on the Table:
Risk |l¢lor
Age (yeats) WHR SSPG (retool/l) FastingIRI (mU/l) Tot..chollramoFI) LDL-chollmmot/1) HDL.-chol(mmolfl) TG (retool/l) apo-A (retool/l) apo-B (retool/l)
BMI (k~m 2 ) <26
26-30
>30
p
50.4 (9.0) 0.86 (0.12) 7.60 (3.51) 10.37110.04) 5.64 (1.01) 3.09 11.13) 1.59(0.48) 1.34 (0.84) 1.54 (0.33) 1,09 (0.26)
53.9 (10.8) 0.92 10.15) 8.95 (3.88) 10.8616.14) 5.42 (0.84) 3.11 (0.78) 1.20 (0.31) 1.79(I.07) 1.37 (0.21) 1.13 (0.26)
529 ( I I. I ) 0.92 10.10) 10.45 (3.65) 15.44 (8.721 5.82 (1.05) 3.52 (0.76) 1.21 (0.33) 2.55 12.15) 1.32 (0.26) 1.47 (1.271
NS
"" NS NS ""° °°" ""
"p < 0.05. "'p < 0.01, " " p < 0.001 BMI is in positive association with WHR, SSPG, fasting IR1, fasting TG and apo-B, in negative association with HDL--chol and apo A. AI defined as TG > 1.85 and apoB > 1.21 (the 3rd tertile of these variables) was found in 19 subjects (20%) out o f which 11 had BMI > 30. Obesity elevates the presence o f A l 3 times (OR = 3.08, 95% conf. limits 1.03-9.18). Conclusion: Obesity is associated not only with insulin resistance dyslipidemia pattern (Phenotype B) but also with higher apo-B which may contribute to high atherogenic risk. RELATION B E T W E E N BODY FAT DISTRIBUTION AND INSULIN° RESISTANCE IN W O M E N W I T H AND W I T H O U T OBESITY A. Hernhndez, I. Lluch, C. Morillas, R. Royo, C. Meli~i, E. S o l i M.L. Mufioz, H. Pefia, M. G6mez. Endocrinology Department. Dr. Peset
Hospital Valencia, Spain Android distribution of fat is related to plurimetabolic syndrome and increases the cardiovascular risk, although this association is less defined in women than in men. The aim o f this study is to evaluate the relation between android distribution of fat and insulin-resistance in a group of obese and non-obese women. Eighty six women were studied: 35 non-obese (mean age: 44.1+18.2 years, BMI: 22.9-1-2.6 Kg/m 2) and 51 with obesity (mean age: 48.7+13. I years, BMI: 32.7+3.4 Kg/m2). We measured: lipidic profile, fibrinogen, basal glucose and insulin. To evaluate basal insulin-resistance, we
Systolic BP HDLc (mg/dl)
Apo A (mg/dl)
(.ilycemia Insulin (mg/dl) (llUiml)
IR
1234-9 1504-3
1574-22 1404-18
914-11 98±10
I 6±08 31~1
(mmHg)
Normal Obese
604-13 484-7
7.34-3 12.64-4
Conclusions: 1. In women, obesity is related with hypertension, decrease in HDLc, hyperfibrinogenemia and insulin-resistance. 2. Android obesity, is related with more insulin-resistance. 3. The android distribution of fat in obesity, is characterised by more insulinresistance, a decrease in HDLc and diastolic hypertension.
C O R R E L A T I O N A M O N G M E T A B O L I C PROFILE, BLOOD PRESSURE AND ADIPOSE TISSUE IN EXTREMELY OBESE WOMEN E. Stoki(3, T. Ivkovit-Lazar, A. Stoki~ 1, Lj. Lep,~anovi62, L. Lep~;anovi~.
IDept. of Endocrinologl; Dept. of OncoloKv" 2Dept. of PathophysioloKv: Medical Faculty Noui Sad. }itgoslauia We examined a group of 80 obese females (BMh 38.65 +/- 6.35 ktym 2, 40 with android (WHR: 1.16 +/- 0.04) and 40 with gynoid type (WHR: 0.81 +/- 0.01)) in whom, apart from standard measures (body weight, height, body mass index, waist-to-hip ratio), the adipose tissue depots were measured by ultrasonography. In order to study glycoregulation, all obese women passed OGTT with determination of insulinemia. Regarding lipid parameters, total, HDL-, LDL-and VLDL- cholesterol, triglycerides and index of atherosclerosis were determined. Results showed a statistically significant higher visceral adipose tissue in females with android type of obesity comparing the gynoid (28.39 +/10.22 mm vs. 22.88 +/- 226 mm, p < 0.05), but subcutaneous fat tissue was statistically significant higher in the gynoid group (31.29 +/- 6.14 mm vs. 20.79 +/- 8.95, p < 0.001). The values of insulinemia were significantly higher in the android than in the gynoid group in all times during the OGTT (p < 0.01). The hyperinsulinemia was recorded and followed by higher values of total cholesterol (618 + / - 0.77 vs 5 1 8 + / - 0.65 retool/l, p < 0.05), triglycerides (2.75 + / - 0.96 vs. 1.30 + l - 0.43 mmol/I, p < 0.05), LDL..cholesterol (4.51 +/- 0.33 vs. 3.78 +/- 1.64 retool/l, p < 0.05) and lower values of HDL-cholesterol (0.88 +/- .29 vs. 1.14 +/- 0.37 retool/I, p < 0.01) in the android than in the gynoid group, higher values of systolic and diastolic blood pressure in the android than in the gynoid group. Also, our results, in the group of android obese women, showed that there was a significant association among values o f visceral adipose tissue and lipid disorders, hypeinsulinism and higher values of systolic and diastolic blood pressure. Our results suggest that the ultrasound measuring could be used as a very valuable parameter in order to distinguish the obese persons with the risky metabolic profile.
71st EAS.Congress and Satellite Symposia