Obesity and insulin resistance in apparently healthy Korean men / 대한내과학회지

ABSTRACT

BACKGROUND: Several reports document Asians have a strong tendency of developing insulin resistance. We aimed to evaluate the relative effects of insulin resistance and obesity on coronary heart disease (CHD) risk factors and to clarify whether insulin resistance accentuates the effect of obesity on CHD risk factors in apparently healthy men. METHODS: We conducted the cross-sectional survey of 4,067 apparently healthy Korean men aged 20-83 years, with a body mass index (BMI) ranging from 15.19 to 40.29 kgm-2. Insulin resistance was defined as the highest decile of homeostasis model assessment (HOMA-IR) in the lean group (BMI<23 kgm-2; 1,438 subjects). RESULTS: The prevalence of insulin resistance was 24.7% in the overweight subgroup (23cholesterol (TC) and low density lipoprotein cholesterol (LDL). Waist circumference (WC) was the most important determinant for apolipoprotein B (Apo B), systolic and diastolic blood pressure (SBP and DBP), and C-reactive protein (CRP). HOMA-IR was the strongest predictor for fasting blood sugar (FBS), triglyceride (TG), decreasing high density lipoprotein cholesterol (HDL) and apolipoprotein A-I (Apo A-I), and TC/HDL. The presence of insulin resistance accentuates CHD risk factors except LDL and Apo A-I in the obese.

CONCLUSION:

WC is closely associated with non-traditional markers for CHD, such as raised Apo B, hypertriglyceridaemia, and TC/HDL ratio predicting small, dense LDL particles. Insulin resistance in the obese men is more prevalent than would be expected and accentuates the effect of obesity on CHD risk factors.