Korean J Med.
2003 May;64(5):552-560.
The relative risks of the metabolic syndrome defined by adult treatment panel III according to insulin resistance in Korean population
- Affiliations
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- 1Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea. drlwy@samsung.co.kr
Abstract
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BACKGROUND: Metabolic syndrome (MS) is a cluster of the risk factors of cardiovascular disease and type 2 diabetes that share physiologic antecedent resistance to insulin. Subjects with MS are about twice as likely to develop cardiovascular disease and over four times as likely to develop type 2 diabetes compared with people who do not have MS. We analyzed the association between MS and insulin resistance to investigate the effects of insulin resistance on the development of MS and it's risk factors.
METHODS
MS was defined by third report of the national cholesterol education program (NCEP) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (Adult Treatment Panel III) (ATP III), and abdominal obesity was determined by Asia-Pacific criteria in waist circumference. Total 7,057 participants (4,472 men, 2,585 women) underwent medical screening from Jan. to May 2002 were enrolled in this study. We assessed the clinical characteristics of subjects and homeostatic model assessment (HOMA) as an index of insulin resistance.
RESULTS
The prevalence of MS by definition of ATP III was 8.8% (10.6% in male, 5.8% in female), and by Asia-Pacific criteria in waist circumference was 12.6% (13.9% in male, 10.3% in female). The odds ratio of MS were significantly higher in subjects with higher insulin resistance (higher HOMA and higher fasting insulin concentrations) compared to those with lower insulin resistance. According to the increased numbers of the components of MS, the means of HOMA and the concentrations of fasting insulin were significantly higher. The higher HOMA (>or=2.78) and fasting insulin concentration (>or=10.15 micro IU/mL) were remained as independent risk factors of MS after logistic multiple regression analysis with age, sex and body mass index (p<0.001).
CONCLUSION
Theses results show that metabolic syndrome is excellently correlated with the index of insulin resistance, and the appropriate values of HOMA and fasting insulin concentration may serve as a good screening test of metabolic syndrome and a parameter of follow-up during the treatment.
