PMID- 8283160
OWN - NLM
STAT- MEDLINE
DCOM- 19940215
LR  - 20190904
IS  - 0954-6820 (Print)
IS  - 0954-6820 (Linking)
VI  - 235
IP  - 1
DP  - 1994 Jan
TI  - Hyperinsulinaemia, obesity, and syndrome X.
PG  - 51-6
AB  - OBJECTIVE: The major aim of this study was to compare various aspects of 
      carbohydrate, insulin, and lipoprotein metabolism, serum uric acid concentration, 
      and blood pressure in normal subjects stratified on the basis of both plasma 
      insulin concentration and degree of obesity. The hypothesis to be tested was that 
      hyperinsulinaemia, per se, was associated with relative glucose intolerance, 
      higher triglyceride and uric acid concentrations, lower high-density lipoprotein 
      cholesterol concentration and higher blood pressure, irrespective of degree of 
      obesity. DESIGN: This represents a case-control study, in which normal volunteers 
      were subdivided into four equal groups based upon degree of obesity and plasma 
      insulin response to a 74 g oral glucose challenge. SETTING: The study was 
      performed in the out-patient clinic of a university hospital. SUBJECTS: 
      Sixty-four individuals were recruited for this study, subdivided into four groups 
      based upon their plasma insulin concentration and body mass index. Subjects were 
      classified as hyperinsulinaemic if their plasma insulin concentrations in 
      response to an oral glucose challenge were more than two standard deviations 
      above the mean of 732 volunteers previously studied [1]. Obesity was defined as a 
      body mass index of > 30 kg m-2, and individuals were classified as non-obese if 
      their body mass index was < 27.0 kg m-2. Based upon these criteria, four 
      experimental groups were created: (i) non-obese hyperinsulinaemic (NOB hyper); 
      (ii) obese hyperinsulinaemic (OB hyper); (iii) non-obese normoinsulinaemic (NOB 
      normo); and (iv) obese normoinsulinaemic (OB normo). MAIN OUTCOME MEASURES: 
      Subject groups were compared on the basis of the integrated plasma glucose 
      response to a 75 g oral glucose challenge, fasting plasma triglyceride, 
      cholesterol, high-density lipoprotein cholesterol, and uric acid concentrations, 
      and blood pressure. RESULTS: Mean (+/- standard error of the mean) integrated 
      plasma glucose response area for 2 h following a 75 g oral glucose load was 
      significantly higher (13.4 +/- 0.4 vs. 11.0 +/- 0.4 mmol l-1, P < 0.001) in the 
      hyperinsulinaemic group, as were the fasting triglyceride levels (2.4 +/- 0.2 vs. 
      1.4 +/- 0.1 mmol l-1, P < 0.001) and uric acid (5.3 +/- 0.2 vs. 4.4 +/- 0.2 mmol 
      l-1, P < 0.05) concentrations. In contrast, high-density lipoprotein 
      concentrations were lower in the hyperinsulinaemic group (1.06.0.05 vs. 1.32 +/- 
      0.05 mmol l-1, P < 0.001). In addition, blood pressure was higher in the 
      hyperinsulinaemic group (136 +/- 5/87 +/- 2 vs. 123 +/- 2/82 +/- 1 mmHg, P < 
      0.05). Furthermore, when each of the two groups were divided into obese (n = 16) 
      and non-obese (n = 16) groups, all of the differences outlined above persisted. 
      These changes were independent of age, gender distribution, generalized and 
      abdominal obesity, cigarette smoking, and estimated physical activity. 
      CONCLUSIONS: The cluster of changes subsumed under the heading of syndrome X are 
      closely associated with hyperinsulinaemia (and presumably insulin resistance), 
      and can be discerned irrespective of degree of obesity.
FAU - Zavaroni, I
AU  - Zavaroni I
AD  - Institute of General Clinical Medicine, Parma University, Italy.
FAU - Bonini, L
AU  - Bonini L
FAU - Fantuzzi, M
AU  - Fantuzzi M
FAU - Dall'Aglio, E
AU  - Dall'Aglio E
FAU - Passeri, M
AU  - Passeri M
FAU - Reaven, G M
AU  - Reaven GM
LA  - eng
GR  - HL 08506/HL/NHLBI NIH HHS/United States
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PT  - Research Support, U.S. Gov't, P.H.S.
PL  - England
TA  - J Intern Med
JT  - Journal of internal medicine
JID - 8904841
RN  - 0 (Blood Glucose)
RN  - 0 (Insulin)
RN  - 0 (Lipids)
RN  - 268B43MJ25 (Uric Acid)
SB  - IM
MH  - Adult
MH  - Blood Glucose/analysis
MH  - Blood Pressure/physiology
MH  - Body Mass Index
MH  - Case-Control Studies
MH  - Female
MH  - Humans
MH  - Hyperinsulinism/blood/*complications/physiopathology
MH  - Insulin/blood
MH  - Lipids/blood
MH  - Male
MH  - Microvascular Angina/blood/*complications/physiopathology
MH  - Middle Aged
MH  - Obesity/blood/*complications/physiopathology
MH  - Uric Acid/blood
EDAT- 1994/01/01 00:00
MHDA- 1994/01/01 00:01
CRDT- 1994/01/01 00:00
PHST- 1994/01/01 00:00 [pubmed]
PHST- 1994/01/01 00:01 [medline]
PHST- 1994/01/01 00:00 [entrez]
AID - 10.1111/j.1365-2796.1994.tb01031.x [doi]
PST - ppublish
SO  - J Intern Med. 1994 Jan;235(1):51-6. doi: 10.1111/j.1365-2796.1994.tb01031.x.