Insulin resistance in rheumatoid arthritis: relationship to lipid metabolism disorders and metabolic syndrome

Objective:to determine the incidence of insulin resistance (IR) in patients with rheumatoid arthritis (RA) and to assess the relationship of IR to blood lipid profile changes and the presence of metabolic syndrome (MS).Subjects and methods.The investigation enrolled 47 RA patients (41 women and 6 men) without a history of diabetes mellitus (DM) and with normal fasting glucose levels during examination. The patients' median age was 56 [39; 62] years; disease duration – 6 [5; 14] years. Most of the patients had low (40.4%) or moderate (42.6%) RA activity (DAS28). IR was diagnosed using the Homeostastic Model Assessment of Insulin Resistance (HOMA-IR) index 2.77. The presence of MS was assessed by the National Cholesterol Education Program/Adult Treatment Panel III (NCEP/ATPIII) criteria and the International Diabetes Federation (IDF) criteria.Results and discussion.The median HOMA-IR value in RA patients was 1.7 [1.1; 3.2]. The HOMA-IR index correlated with age (r=0.3; p=0.04), body mass index (r=0.6; p<0.001), waist circumference (r=0.6; p<0.001), and the concentrations of total cholesterol (r=0.3; p=0.02) and triglycerides (TG) (r=0.5; p<0.001). All the patients were divided into two groups: 1) 15 patients with IR; 2) 32 patients without IR. The patients of both groups were matched for sex, age, RA duration and activity, and therapy, but the RA patients with IR more often had abdominal obesity (100.0 and 37.5%), hypertriglyceridemia (33.3 and 6.3%) and the atherogenic index >3.0 (40.0 and 6.3%, respectively; p<0.05 in all cases). MS was diagnosed using the NCEP/ATPIII criteria in 46.7% of cases with RI and in 6.3% of those without IR; MS was identified by the IDF criteria in 60.0 and 12.5% of cases, respectively (p<0.01 in all cases). There were no differences between groups in the incidence of hypertension, myocardial infarction, or in the frequency of surgeries for myocardial revascularization.Conclusion.More than 30% of RA patients without DM have IR (HOMA-IR ≥2.77). IR in RA is associated with obesity, elevated blood TG levels, and a proatherogenic lipid profile. The use of the criteria for MS could not always allows suspect IR in patients with RA.

Download Full-text

Effect of leptin on the gallbladder in patients with metabolic syndrome

Clinical Medicine (Russian Journal) ◽

10.18821/0023-2149-2016-94-4-285-289 ◽

2016 ◽

Vol 94 (4) ◽

pp. 285-289 ◽

Cited By ~ 1

Author(s):

Natalia G. Virstyuk ◽

N. R. Senyutovich

Keyword(s):

Insulin Resistance ◽

Metabolic Syndrome ◽

International Diabetes Federation ◽

Resistance Index ◽

High Density Lipoproteins ◽

Control Group ◽

Blood Levels ◽

Model Assessment ◽

Functional Changes ◽

Group I

The study involved 58 patients with chronic noncalculous cholecystitis (CNC) divided into two groups. Group I included 30 CNC patients with metabolic syndrome (MS), group II 28 CNC patients without MS. The control group consisted of 20 healthy people. MS was diagnosed according to International Diabetes Federation guidelines (2005). The following anthropometric parameters were determined: body mass index (BMI), waist to hip ratio, blood lipid profile (total cholesterol, triglycerides, high density lipoproteins (HDL), and low density lipoproteins (LDL)). Leptin and insulin levels were measured using commercial ELISA kits «Leptin ELISA» and «Insulin ELISA» (DRG International, Inc., USA) respectively. Insulin resistance index HOMA-IR (Homeostasis Model Assessment of Insulin Resistance) was calculated. It was shown that leptin level in CNC patients with MS was 2.61 times that in healthy subjects (p <0.001) and 2.47 times higher than in CNC patients without MS (p <0.001). Significant direct correlations between leptin blood levels andBMI, HOMA-IR index, triglycerides, and cholesterol were documented. The relationships between blood levels of leptin and the thickness of the gallbladder (GB) wall, the amount of cholesterol crystals in bile, and decreased bile release rate from GB which suggests effect of leptin on the structural and functional changes in GB.

Download Full-text

Melatonin Potentiates the Therapeutic Effects of Metformin in Women with Metabolic Syndrome

Scientia Pharmaceutica ◽

10.3390/scipharm88020028 ◽

2020 ◽

Vol 88 (2) ◽

pp. 28

Author(s):

Sattar J. Abood ◽

Waleed K. Abdulsahib ◽

Saad A. Hussain ◽

Sajida H. Ismail

Keyword(s):

Insulin Resistance ◽

Metabolic Syndrome ◽

Lipid Profile ◽

Treatment Protocol ◽

International Diabetes Federation ◽

Controlled Study ◽

Controlled Clinical Trial ◽

Therapeutic Effects ◽

Double Blind ◽

Once Daily

Objective: This study evaluated the effect of melatonin on the response of patients suffering from metabolic syndrome (MEBS) treated with metformin. Design: This study used two-armed groups in a double-blind, randomized controlled clinical trial. Materials and Methods: A randomized double-blind placebo-controlled study was carried out on female patients diagnosed as having MEBS, according to the International Diabetes Federation (IDF) diagnosing criteria of MEBS (2005), from the outpatient clinic in Al-Zahraa Teaching Hospital/Kut, Iraq. They were diagnosed utilizing laboratory and clinical investigations, then randomized into two groups. The first group (group A) was treated with metformin (500 mg) twice daily, in addition to a placebo formula once daily at bedtime for three months. The second group (group B) was treated with metformin (500 mg) twice daily after meals, in addition to melatonin (10 mg) once daily at bedtime for three months. Results: The treatment of patients with MEBS using metformin–melatonin showed an improvement in most MEBS components such as fasting serum glucose (FSG), lipid profile, and body mass index (BMI), in addition to a reduction in insulin resistance and hyperinsulinemia. Simultaneously, there were increments in serum uric acid (UA), leptin, prolactin (PRL), and estradiol levels, while serum progesterone level decreased. Furthermore, patients treated with metformin–placebo showed less improvement in the studied parameters compared to that produced due to the inclusion of melatonin in the treatment protocol. Conclusion: Melatonin improves the effect of metformin on several components of MEBS such as FSG, lipid profile, and BMI, in addition to insulin resistance and hyperinsulinemia, compared to metformin alone.

Download Full-text

Mealtime habits and risk of developing the metabolic syndrome or insulin resistance among Mexican adults

British Journal Of Nutrition ◽

10.1017/s0007114516003329 ◽

2016 ◽

Vol 116 (10) ◽

pp. 1824-1833 ◽

Cited By ~ 2

Author(s):

Pablo Méndez-Hernández ◽

Libia Darina Dosamantes-Carrasco ◽

Carole Siani ◽

Romain Pierlot ◽

Margarita Martínez-Gómez ◽

...

Keyword(s):

Insulin Resistance ◽

Metabolic Syndrome ◽

Health Workers ◽

Eating Habits ◽

International Diabetes Federation ◽

Model Assessment ◽

Relative Risks ◽

The Metabolic Syndrome ◽

Mexican Adults ◽

The Relationship

AbstractMeals are an important source of food intake, contributing to body weight and health status. Previous studies have examined the relationship between isolated mealtime behaviours and the metabolic syndrome (MetS). The aim of this study was to examine the influence over time of ten interrelated mealtime habits on the risk of developing the MetS and insulin resistance (IR) among Mexican adults. We conducted a prospective cohort study with a sample of 956 health workers. The Mealtime Habits Quality (MHQ) scale is based on four mealtime situations (availability of time to eat, distractions while eating, environmental and social context of eating, and familiar or cultural eating habits), which were used to assess the participants’ MHQ at the baseline (2004–2006) and follow-up (2010–2012) evaluations. The MetS was assessed using criteria from the National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATP III) and the International Diabetes Federation (IDF). IR was defined using the homoeostasis model assessment. Crude and adjusted relative risks were calculated to estimate the relationship between MHQ and the risk of developing the MetS or IR. Participants classified in the lower MHQ category had an 8·8 (95 % CI 3·1, 25) and 11·1 (95 % CI 3·4, 36·1) times greater risk of developing the MetS (using the NCEP-ATP III and IDF criteria, respectively), and an 11·2 times (95 % CI 3·9, 31·5) greater likelihood of developing IR, compared with those in the higher MHQ group. This prospective study reveals that individuals who engaged in more undesirable than recommended mealtime behaviours had a >10-fold risk of developing the MetS or IR.

Download Full-text

Vitamin D Supplementation Does Not Affect Metabolic Changes Seen With ART Initiation

Open Forum Infectious Diseases ◽

10.1093/ofid/ofx210 ◽

2017 ◽

Vol 4 (4) ◽

Cited By ~ 4

Author(s):

Josh Muhammad ◽

Ellen S Chan ◽

Todd T Brown ◽

Pablo Tebas ◽

Grace A McComsey ◽

...

Keyword(s):

Insulin Resistance ◽

Metabolic Syndrome ◽

Vitamin D ◽

Lipid Profile ◽

Density Lipoprotein ◽

Vitamin D Supplementation ◽

Lipoprotein Cholesterol ◽

Controlled Study ◽

Model Assessment ◽

Art Initiation

Abstract Background Insulin resistance and lipid changes are common after antiretroviral therapy (ART) initiation. Observational studies suggest that vitamin D supplementation reduces the risk of developing diabetes and improves lipid profiles. Methods This 48-week prospective, randomized, double-blind, placebo-controlled study evaluated high-dose vitamin D3 (4000 IU daily) plus calcium supplementation (1000 mg calcium carbonate daily) in HIV-infected participants initiating ART with efavirenz/emtricitabine/tenofovir (EFV/FTC/TDF). Changes in insulin resistance (as estimated by homeostatic model assessment), fasting lipid profile, and components of the metabolic syndrome were assessed at baseline, 24 weeks, and 48 weeks. Stratified Wilcoxon rank sum tests and stratified normal score tests were used to evaluate differences between treatment arms, stratified by screening 25-OH vitamin D stratum (≤/>20 ng/mL). Results A total of 165 participants enrolled: 79 in the vitamin D/calcium (Vit D/Cal) arm and 86 in the placebo arm. Only the placebo arm experienced a modest increase in insulin resistance at week 24 (P < .001). While increases in total and high-density lipoprotein cholesterol were significant in both arms at weeks 24 and 48, increases in low-density lipoprotein cholesterol at week 24 were only identified in the placebo arm (P = .011). Body mass index remained stable, whereas modest increases in waist circumference were observed in the placebo arm. Metabolic syndrome was present in 19 participants (12%) at baseline and 20 participants (14%) at week 48, without differences between arms. Conclusions Vit D/Cal supplementation over 48 weeks did not alter the lipid profile or glucose metabolism experienced with initiation of EFV/FTC/TDF in ART-naïve persons. Vitamin D supplementation is unlikely to be an effective strategy to attenuate metabolic dysregulations with ART initiation.

Download Full-text

FGF21 and its Relationship with Inflammatory and Metabolic Parameters in HIV Patients after Antiretroviral Treatment

Current HIV Research ◽

10.2174/1570162x18666200719235625 ◽

2020 ◽

Vol 18 (5) ◽

pp. 308-314

Author(s):

Alan Joel Ruiz-Padilla ◽

Yeniley Ruiz-Noa ◽

Lorena del Rocio Ibarra-Reynoso ◽

Maria-Luisa Lazo-de-la-Vega-Monroy ◽

Angel Josabad Alonso-Castro ◽

...

Keyword(s):

Insulin Resistance ◽

Antiretroviral Therapy ◽

Lipid Profile ◽

Serum Levels ◽

Atherogenic Index ◽

Fibroblast Growth Factor 21 ◽

Model Assessment ◽

Hiv Patients ◽

Inflammatory Status ◽

Increased Risk

Background: Fibroblast Growth Factor 21 (FGF21) serum levels are associated with insulin resistance and metabolic syndrome in HIV patients. Objective: To quantify FGF21 levels in HIV patients using antiretroviral therapy (ART) and to analyze a possible association between serum FGF21 levels and lipid profile, levels of proinflammatory cytokines, and atherogenic risk factors. Materials and Methods: Twenty patients with HIV infection, who received ART in a scheme consisting of Tenofovir/Emtricitabine+Lopinavir/Ritonavir, were enrolled in this study. The serum levels of FGF21, inflammatory parameters (IL-6 and IL-1β), glucose, cholesterol, triglycerides, and insulin were determined at baseline and after 36 weeks of treatment. The homeostatic model assessment for insulin resistance (HOMA-IR) and the atherogenic risk factor were also calculated. Results: After 36 weeks, serum FGF21 levels decreased significantly (p=0.011), whereas IL-6 levels (r=0.821, p=0.0001) and the CD4+ T cell count (r=0.446, p=0.048), showed a positive correlation with the decrease in FGF21 levels. There was an increase in total cholesterol (r=-0.483, p=0.031), LDL (r=-0.496, p=0.026), VLDL (r=-0.320, p=0.045), and the atherogenic index factor (r=-0.539, p=0.014), these values showed a negative correlation with FGF21 levels. Conclusions: The decrease of serum FGF21 levels due to ART is associated with the alteration in lipid profile and an increased risk for cardiovascular diseases. These variations are predictors of inflammatory status in HIV patients using antiretroviral therapy.

Download Full-text

Is FGF23 effective on insulin resistance in individuals with metabolic syndrome?

Hormone Molecular Biology and Clinical Investigation ◽

10.1515/hmbci-2018-0018 ◽

2018 ◽

Vol 35 (2) ◽

Cited By ~ 1

Author(s):

Dede Sit ◽

Ender Tanrıverdi ◽

Hasan Kayabasi ◽

Muslum Erdem ◽

Hakan Sari

Keyword(s):

Insulin Resistance ◽

Metabolic Syndrome ◽

Fibroblast Growth Factor 23 ◽

International Diabetes Federation ◽

Enzyme Linked Immunosorbent Assay ◽

Control Group ◽

High Morbidity ◽

Model Assessment ◽

Significant Difference ◽

And Control

AbstractPurposeMetabolic syndrome (MetS) is a polymetabolic syndrome has high morbidity and mortality rates. Insulin resistance (IR) plays a key role in the increasing frequency of this situation and has been cited as being an important etiologic factor in MetS. In this study, the relationship between IR and fibroblast growth factor-23 (FGF23), was investigated in a population with MetS.Materials and methodsForty patients with diagnosis of MetS and 40 healthy volunteers with an equal number of males and females were included in the study and classified as patient group and control group. Blood samples were obtained after 12-h fasting period to study FGF23 and other parameters. MetS, defined according to the International Diabetes Federation (IDF) guidelines, FGF23 was studied by Enzyme-Linked ImmunoSorbent Assay (ELISA) method and IR was calculated using the homeostatic model assessment-insulin resistance (HOMA-IR) formula.ResultsThere was a statistically significant difference in HOMA-IR between the patient and control group as expected, while levels of FGF23 were similar. According to gender, levels of FGF23 was statistically significantly higher in male patients compared with controls (p = 0.037). A relationship was not detected between HOMA-IR and FGF23 in the correlation analysis.ConclusionAlthough there are many studies suggesting the correlation between FGF23 and IR in different populations, we did not find any statistically significant relationship between IR and FGF23 levels in MetS in this study.

Download Full-text

Association of Fasting Lipid Profile with Insulin Resistance in Non-Alcoholic Fatty Liver Disease Patients

Chattagram Maa-O-Shishu Hospital Medical College Journal ◽

10.3329/cmoshmcj.v20i2.56464 ◽

2021 ◽

Vol 20 (2) ◽

pp. 3-7

Author(s):

Farhad Hussain ◽

Rehana Aziz ◽

Pijush Karmakar ◽

Md Hasan Murad Chowdhury ◽

Asma Hoque ◽

...

Keyword(s):

Insulin Resistance ◽

Metabolic Syndrome ◽

Liver Disease ◽

Fatty Liver ◽

Lipid Profile ◽

Fatty Liver Disease ◽

Model Assessment ◽

Alcoholic Fatty Liver ◽

The Metabolic Syndrome ◽

Alcoholic Fatty Liver Disease

Back ground: Non-Alcoholic Fatty Liver Disease (NAFLD) is a common cause of Chronic Liver Disease (CLD) worldwide and is becoming a major public health problem. NAFLD has been recognized as a hepatic manifestation of Metabolic Syndrome (MetS) linked with Insulin Resistance (IR) and is currently considered as the hepatic component of the Metabolic Syndrome (MetS). NAFLD is strongly associated with IR and is mostly silent which is often discovered incidentally through elevated hepatic enzyme levels. The purpose of this study is to find out the association of Fasting Lipid Profile (FLP) with IR in NAFLD subjects. Materials and methods: A prospective hospital based cross sectional study was carried out in the Department Of Biochemistry, Institute of Nuclear Medicine and Allied Sciences (INMAS) and Chittagong Medical College Hospital. One hundred & fifty (150) subjects aging between 18-60 years were included in this study by non probability consecutive sampling method. Important variables in this study were Fasting Plasma Glucose (FPG) Fasting Serum Insulin (FPI) and Fasting Lipid Profile (FLP). IR was calculated by using Homeostasis Model Assessment of Insulin Resistance (HOMA-IR) index i.e. (FPI μIU x FPG mmol/L)/22.5. Results: In this study HOMA-IR was significantly higher in cases than that of controls (4.77±0.16) and showing Insulin Resistance (IR) in 90% of the cases. There was a significant association of HOMA-IR with increased serum Triglyceride (TG) in NAFLD cases. Conclusion: The findings of the current study suggest that independent variable such as increased Serum TG was associated with IR in NAFLD subjects. Chatt Maa Shi Hosp Med Coll J; Vol.20 (2); July 2021; Page 3-7

Download Full-text

Association of Serum Levels of Zinc, Copper, and Iron with Risk of Metabolic Syndrome

Nutrients ◽

10.3390/nu13020548 ◽

2021 ◽

Vol 13 (2) ◽

pp. 548

Author(s):

Chia-Wen Lu ◽

Yi-Chen Lee ◽

Chia-Sheng Kuo ◽

Chien-Hsieh Chiang ◽

Hao-Hsiang Chang ◽

...

Keyword(s):

Insulin Resistance ◽

Metabolic Syndrome ◽

Linear Models ◽

Serum Zinc ◽

Serum Levels ◽

Least Square ◽

Model Assessment ◽

Serum Concentrations ◽

Metabolic Factors ◽

Homeostatic Model Assessment

The association between serum concentrations of zinc, copper, or iron and the risk of metabolic syndrome are inconclusive. Therefore, we conduct a case-control study to explore the relationship between serum levels of zinc, copper, or iron and metabolic syndrome as well as each metabolic factor and insulin resistance. We enrolled 1165 adults, aged ≥ 40 (65.8 ± 10) years in a hospital-based population to compare the serum levels of zinc, copper, and iron between subjects with and without metabolic syndrome by using multivariate logistic regression analyses. The least square means were computed by general linear models to compare serum concentrations of zinc, copper, and iron in relation to the number of metabolic factors. The mean serum concentrations of zinc, copper, and iron were 941.91 ± 333.63 μg/L, 1043.45 ± 306.36 μg/L, and 1246.83 ± 538.13 μg/L, respectively. The odds ratios (ORs) of metabolic syndrome for the highest versus the lowest quartile were 5.83 (95% CI: 3.35–10.12; p for trend < 0.001) for zinc, 2.02 (95% CI: 1.25–3.25; p for trend: 0.013) for copper, and 2.11 (95% CI: 1.24–3.62; p for trend: 0.021) for iron after adjusting for age, sex, personal habits, body mass index, and homeostatic model assessment insulin resistance. Additionally, the serum zinc, copper, and iron concentrations increased as the number of metabolic factors rose (p for trend < 0.001). This was the first study to clearly demonstrate that higher serum levels of zinc, copper, and iron were associated with the risk of metabolic syndrome and the number of metabolic factors independent of BMI and insulin resistance.

Download Full-text

SAT0111 THE RELATIONSHIP BETWEEN THE ADMINISTRATION OF IL-6 INHIBITORS AND INSULIN RESISTANCE IN PATIENTS WITH ACTIVE RHEUMATOID ARTHRITIS

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2020-eular.6509 ◽

2020 ◽

Vol 79 (Suppl 1) ◽

pp. 989.3-989

Author(s):

A. Jitaru ◽

C. Pomirleanu ◽

M. M. Leon-Constantin ◽

F. Mitu ◽

C. Ancuta

Keyword(s):

Rheumatoid Arthritis ◽

Insulin Resistance ◽

Insulin Sensitivity ◽

Beneficial Effect ◽

Disease Activity ◽

Interleukin 6 ◽

Normal Weight ◽

Diabetic Patients ◽

Model Assessment ◽

Inflammatory Status

Background:Rheumatoid arthritis (RA) is associated with an increased cardiovascular (CV) risk, due not only to the traditional risk factors (hypertension, insulin resistance/diabetes, obesity, smoking), but to the inflammatory status as well. The blockade of interleukin-6 (IL-6) can regulate the glucose metabolism, reducing the glucose level and insulin resistance (IR). This beneficial effect is seen more in patients with normal values of body mass index (BMI), compared to the obese population.Objectives:Given the mentioned existing data, we aim to demonstrate the positive effect of IL-6 inhibitors in active RA patients with normal or increased BMI.Methods:We recruited 56 consecutive patients with definite and active RA, non-responders/partial responders to conventional synthetic Drug Modifying Anti-Rheumatic Drugs (csDMARDs)/biological therapy. For a period of 52 weeks, patients received subcutaneous Tocilizumab (TCZ) in a dose of 162mg once a week, according to European League Anti Rheumatism (EULAR) recommendation and National Protocol. We assessed demographics, RA-related parameters (clinical, inflammatory and immune) and metabolic markers, as well as the peripheral response to insulin, quantified by Homeostasis Model Assessment for insulin resistance (HOMA-IR) and the Quantitative Insulin Sensitivity Check Index (QUICKI). We did not include in the study the patients known with diabetes mellitus (DM) and those undergoing glucocorticoids.Results:After 52 weeks of treatment, most of the patients showed a statistically significant reduction of HOMA-IR (3.61 ± 1.21 at the onset vs. 2.45 ± 1.46 at the end of the study, p<0.001), while QUICKI registered a slight increase (0.32 ± 0.01 at the onset vs. 0.33 ± 0.01 at the end of the study, p<0.001). Also, the decrease in insulin and glucose levels were more obvious in patients with normal BMI, strictly related to disease activity.Conclusion:Long-term administration of TCZ in active RA is associated with a significant reduction of disease activity and IR, especially in normal weight patients. This confirms that obesity, as a CV risk factor, represents one of the main causes of IR.References:[1]Castañeda S, Remuzgo-Martínez S, López-Mejías R et al. Rapid beneficial effect of the IL-6 receptor blockade on insulin resistance and insulin sensitivity in non-diabetic patients with rheumatoid arthritis.Clin Exp Rheumatol. 2019; 37(3):465-473.[2]Lehrskov LL, Christensen RH. The role of interleukin-6 in glucose homeostasis and lipid metabolism.Semin Immunopathol. 2019; 41(4):491-499.[3]Ursini F, Russo E, Ruscitti P, Giacomelli R, De Sarro G. The effect of non-TNF-targeted biologics and small molecules on insulin resistance in inflammatory arthritis.Autoimmun Rev. 2018 Apr;17(4):399-404.Disclosure of Interests:Alexandra Jitaru: None declared, Cristina Pomirleanu: None declared, Maria-Magdalena Leon-Constantin: None declared, Florin Mitu: None declared, CODRINA ANCUTA Consultant of: AbbVie, Pfizer, Roche, Novartis, UCB, Ewopharma, Merck Sharpe and Dohme, and Eli Lilly, Speakers bureau: AbbVie, Pfizer, Roche, Novartis, UCB, Ewopharma, Merck Sharpe and Dohme, and Eli Lilly

Download Full-text

Homeostasis model assessment of insulin resistance (HOMA-IR) and metabolic syndrome at baseline of a multicentric Brazilian cohort: ELSA-Brasil study

Cadernos de Saúde Pública ◽

10.1590/0102-311x00072120 ◽

2020 ◽

Vol 36 (8) ◽

Author(s):

Maria de Fátima Haueisen Sander Diniz ◽

Alline Maria Rezende Beleigoli ◽

Maria Inês Schmidt ◽

Bruce B. Duncan ◽

Antônio Luiz P. Ribeiro ◽

...

Keyword(s):

Insulin Resistance ◽

Metabolic Syndrome ◽

Normal Weight ◽

Overweight And Obesity ◽

Model Assessment ◽

Adult Health ◽

Homeostasis Model Assessment ◽

The Metabolic Syndrome ◽

Brazilian Cohort ◽

Overweight Or Obesity

Abstract: Homeostasis model assessment of insulin resistance (HOMA-IR) is a method to measure insulin resistance. HOMA-IR cut-offs for identifying metabolic syndrome might vary across populations and body mass index (BMI) levels. We aimed to investigate HOMA-insulin resistance cut-offs that best discriminate individuals with insulin resistance and with metabolic syndrome for each BMI category in a large sample of adults without diabetes in the baseline of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). Among the 12,313 participants with mean age of 51.2 (SD 8.9) years, the prevalence of metabolic syndrome was 34.6%, and 60.1% had overweight or obesity. The prevalence of metabolic syndrome among normal weight, overweight and obesity categories were, respectively, 13%, 43.2% and 60.7%. The point of maximum combined sensitivity and specificity of HOMA-IR to discriminate the metabolic syndrome was 2.35 in the whole sample, with increasing values at higher BMI categories. This investigation contributes to better understanding HOMA-IR values associated with insulin resistance and metabolic syndrome in a large Brazilian adult sample, and that use of cut-off points according to ROC curve may be the better strategy. It also suggests that different values might be appropriate across BMI categories.

Download Full-text