Tissue Recovery

J Am Coll Cardiol. 2002 Sep 4;40(5):937-43.

Clinical study: obesity, diabetes, and heart disease

Relationship between obesity, insulin resistance, and coronary heart disease risk
Fahim Abbasi MD, Byron William Brown, Jr PhD, Cindy Lamendola MSN, ANP, Tracey McLaughlin MD and Gerald M. Reaven MD

* Department of Medicine, Stanford, California, USA
Department of Health Research and Policy, Stanford University School of Medicine, Stanford, California, USA

Received 27 August 2001;  revised 19 March 2002;  accepted 4 June 2002.  Available online 10 September 2002.

Abstract

Objectives

The study goals were to: 1) define the relationship between body mass index (BMI) and insulin resistance in 314 nondiabetic, normotensive, healthy volunteers; and 2) determine the relationship between each of these two variables and coronary heart disease (CHD) risk factors.

Background

The importance of obesity as a risk factor for type 2 diabetes and hypertension is well-recognized, but its role as a CHD risk factor in nondiabetic, normotensive individuals is less well established.

Methods

Insulin resistance was quantified by determining the steady-state plasma glucose (SSPG) concentration during the last 30 min of a 180-min infusion of octreotide, glucose, and insulin. In addition, nine CHD risk factors: age, systolic blood pressure, diastolic blood pressure (DBP), total cholesterol, triglycerides (TG), high-density lipoprotein (HDL) cholesterol and low-density lipoprotein cholesterol concentrations, and glucose and insulin responses to a 75-g oral glucose load were measured in the volunteers.

Results

The BMI and the SSPG concentration were significantly related (r = 0.465, p < 0.001). The BMI and SSPG were both independently associated with each of the nine risk factors. In multiple regression analysis, SSPG concentration added modest to substantial power to BMI with regard to the prediction of DBP, HDL cholesterol and TG concentrations, and the glucose and insulin responses.

Conclusions

Obesity and insulin resistance are both powerful predictors of CHD risk, and insulin resistance at any given degree of obesity accentuates the risk of CHD and type 2 diabetes.
Abbreviations: BMI; body mass index; CHD; coronary heart disease; DBP; diastolic blood pressure; EGIR; European Group for the Study of Insulin Resistance; HDL; high-density lipoprotein; LDL; low-density lipoprotein; NHANES; National Health and Nutrition Examination Survey; SBP; systolic blood pressure; SSPG; steady-state plasma glucose; SSPI; steady-state plasma insulin; TG; triglycerides