Browse > Article

The Relation of Cardiovascular Risk Factors to Metabolic Syndrome  

Park, Sat-Byul (Department of Family Medicine, Ajou University School of Medicine)
Publication Information
Korean Journal of Family Medicine / v.26, no.10, 2005 , pp. 614-620 More about this Journal
Abstract
Background: Possible risk factors relating to the development of insulin resistance was analyzed and the clinical availability of metabolic syndrome on insulin resistance was examined to evaluate the relationship between the metabolic syndrome and insulin resistance. Methods: A total of 993 clients were selected according to the criteria of clinical identification by NCEP-ATP III. The metabolic syndrome group was 502 subjects and the control group was 491 subjects. Sociodemographic data and lifestyle factors were surveyed by questionnaire. Height, weight, blood pressure, fasting blood cholesterol, triglyceride, HDL cholesterol, glucose, and insulin levels were measured. W/BH ratio, AI, and HOMA-IR were calculated and analyzed in relation to cardiovascular risk actors. Results: In the metabolic syndrome group, men were significantly greater than women (P＜0.05). The mean age and BMI in the metabolic syndrome group were significantly higher than controls (P＜0.05). The cut-off point for cardiovascular risk factor using the ROC curve with W/BH ratio was 0.529, AI 4.34, HOMA-IR 1.94, and Insulin 6.35 ｕIU. The area under the ROC curve for variables was significantly greater than the reference value (P=0.000). Therefore, W/BH ratio was a strong predictor of incident metabolic syndrome. The study subjects were grouped according to insulin resistance and then the relationship of cardiovascular risk factors was evaluated. Odds ratios of hypertension, hypertriglyceridemia, and low HDL-cholesterolemia were significantly increased in the metabolic syndrome group (P＜0.05), while the individuals with insulin resistance had a much higher incident diabetes than those without it, regardless of whether NCEP criteria for metabolic syndrome was met. The risk of insulin resistance in relation to metabolic risk factors tended to increase after adjustment of life style factors. Conclusion: The diagnostic criteria for the metabolic syndrome was useful in finding out early stage of insulin resistance as an indirect measurement tool. Incident diabetes related to insulin resistance regardless of the presence of metabolic syndrome. Therefore, clinical treatment and life style modification in metabolic syndrome patients may decrease the development of cardiovascular disease and contribute to health promotion. Further study is needed to follow-up on metabolic syndrome patients.
Keywords
metabolic syndrome; insulin resistance; cardiovascular risk factor;
Citations & Related Records
Times Cited By KSCI : 1  (Citation Analysis)
연도 인용수 순위
1 Isomaa B, Almgren P, Tuomi T, Forsen B, Lahti K, Nissen M, et al. Cardiovascular morbidity and mortality associated with the metabolic syndrome. Diabetes Care 2001;24:683-9   DOI   ScienceOn
2 Fontbonne A, Charles MA, Thibult N, Richard JL, Claude JR, Warnet JM, et al. Hyperinsulinemia as a predictor of coronary heart disease mortality in a healthy population: the Paris Prospective Study, 15-year follow up. Diabetologia 1991;34:356-61   DOI   ScienceOn
3 오상우. 인슐린저항성과 비만. 가정의학회지 2002;23 suppl 4:515-9
4 Clinical Guidelines on the Identification. Evaluation and Treatment of Overweight and Obesity in Adults-the Evidence Report. National Institutes of Health. Obes Res 1998;6(suppl 2):S51-209
5 Matthews DR, Hosker JP, Rudenski AS, Naylor BA, Teacher DF, Turner RC. Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia 1985;28:412-9   DOI   ScienceOn
6 DeFonzo RA, Ferrannini E. Insulin resistance: a multifaceted syndrome responsible for NIDDM, obesity, hypertension, dyslipidemia, and atherosclerotic cardiovascular disease. Diabetes Care 1991;14:173-94   DOI   ScienceOn
7 Klatsky AL, Friedman GD, Sieglaus AB. Alcohol and mortality:a ten year Klaiser-Permanete experience. Ann Intern Med 1981;95:139-45   DOI   ScienceOn
8 Hanson RL, Imperatore G, Bennett PH, Knowler WC. Components of the 'metabolic syndrome' and incidence of type 2 diabetes. Diabetes 2002;51(Oct):3120-7   DOI   ScienceOn
9 Examination Committee of Criteria for 'Obesity Disease' in Japan; Japan Society for the study of obesity. New Criteria for 'Obesity Disease' in Japan. Cir J 2002;66:987-92   DOI   ScienceOn
10 Reaven GM. Insulin resistance and compensatory hyperinsulinemia: role in hypertension, dyslipidemia and coronary artery disease. Am Heart J 1991;121:1283   DOI   PUBMED   ScienceOn
11 Centers for Disease Control and preventation (CDC). Cigarette smoking among adults- United States, 1994. MMWR 1996;45:588-90
12 Despres JP, Lemieux I, Dagenais GR, Cantin B, Lamarche B. HDL-cholesterol as a marker of coronary heart disease risk:the Quebec cardiovascular study. Atherosclerosis 2000;153(2):263-72   DOI   ScienceOn
13 Ascaso JF, Romero JT, Lorente RI, Martinez-Valls J, Carmena R. Abdominal obesity, insulin resistance, and metabolic sydrome in a southern Euopean population. Eur J Intern Med 2003;14:101-6   DOI   ScienceOn
14 Wilson PW, D'Agostino RB, Levy D, Belanger AM, Silbershatz H, Kannel WB. Prediction of coronary heart disease using risk factor categories. Circulation 1998;97:1837-47   DOI   ScienceOn
15 Karam JH. Type II diabetes and syndrome X. Pathogenesis and glycemic management. Endocrinol Metab Clin North Am 1992;21(2):329-50
16 김병성. 한국인에서의 대사증후군의 유병률 -일개 대학병원 종합검진센터 수진자를 대상으로-. 대한임상건강증진학회지 2001;2(1):17-25
17 Laakso M. How good a marker is insulin level for insulin resistance? Am J Epidemiol 1993;137:959-65
18 Kanauchi M. A new index of insulin sensitivity obtained from the oral glucose tolerance test applicable to advanced type 2 diabetes. Diabetes Care 2002;25(10):1891-2   DOI   ScienceOn
19 Pannacciulli N, Cantatore FP, Minenna A, Bellacicco M, Giorgino R, De Pergola G. C-reactive protein is independently associated with total body fat, central fat, and insulin resistance in adult women. Int J Obes Relat Metab Disord 2001;25(10):1416-20   DOI   ScienceOn
20 임열리, 황승욱, 심현준, 오은혜, 장유수, 조비룡. ATP III의 진단기준에 따른 대사증후군의 유병률과 관련위험요인 분석. 가정의학회지 2003;24(2):135-43
21 Despres JP, Lamarche B, Mauriege P, Cantin B, Dagenais GR, Moorjani S, et al. Hyperinsulinemia as an independent risk factor for ischemic heart disease. N Engl J Med 1996;334:952-7.   DOI   ScienceOn
22 Reaven GM. Role of insulin resistance in human disease. Diabetes 1988;37:1595-607   DOI   PUBMED   ScienceOn
23 Kannel WB, Wilson PWF, Zhang TJ. The epidemiology of impaired glucose tolerance and hypertension. Am Heart J 1991;121:1268   DOI   ScienceOn
24 Matthews DR, Hosker JP, Rudenski AS, Naylor BA, Treacher DF, Turner RC. Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentration in man. Diabetologia 1985;28:412-9   DOI   ScienceOn
25 Pearson TA, McBride PE, Miller NH, Smith SC. 27th Bethesda Conference: matching the intensity of risk factor management with the hazard for coronary disease events. Task Force 8. Organization of preventive cardiology service. J Am Coll Cardiol. 1996;27(5):1039-47   DOI   ScienceOn
26 Expert panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults. Execute Summary of the 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). JAMA 2001;285(19):2486-96   DOI   PUBMED   ScienceOn