Magnitude of risk factors for type 2 diabetes and cardiovascular disease varies markedly in moderately obese subjects

This study was aimed to test the hypothesis that risk factors for type 2 diabetes mellitus and cardiovascular disease vary markedly in moderately obese subjects depending on differences in the degree of insulin sensitivity. To this end, 211 apparently healthy moderately obese subjects (BMI: 30.0-34.9 kg/m2) were recruited, insulin-mediated glucose uptake as quantified by the insulin suppression test was measured, and metabolic variables known to increase the risk for type 2 diabetes and cardiovascular disease were assessed. Insulin sensitivity was shown to vary 6-fold. Compared with the most insulin-sensitive tertile, the most insulin-resistant tertile of the population had significantly higher systolic and diastolic blood pressure (P<0.001), higher fasting and 2-hour oral glucose load concentrations, higher plasma triglyceride concentrations, lower plasma HDL-cholesterol concentrations, and more prevalent impaired glucose tolerance. As the extent of risk factors for type 2 diabetes and cardiovascular disease varies according to insulin sensitivity degree, stricter therapeutic interventions should be addressed to the most insulin-resistant subsets of obese subjects.

Abstract

Keywords:
Blood pressure – Cardiovascular risk – HDL-cholesterol – IGT – Insulin sensitivity – Obesity – Plasma glucose – Triglycerides – Type 2 diabetes