Affiliation:
1. Departments of Biochemistry, Medicine, Biostatistics and Epidemiology, and Surgery, School of Medicine, East Carolina University Greenville, North Carolina
Abstract
Objective— To examine if the risk for CHD increases progressively with increases in the BMI of normoglycemic, hyperinsulinemic, morbidly obese women (BMI ≥ 35 kg/m2).
Research Design and Methods— Insulin sensitivity was evaluated by calculating an ISI following an OGTT. There was a significant linear relationship between ISI and BMI fitted by two straight lines intersecting at a point corresponding to a BMI of 29.7 ± 1.5 kg/m2. Significant linear relationships between insulin sensitivity and BMI were obtained below and above this breakpoint. Similarly, a breakpoint for the relation between dBP and BMI corresponding to a BMI ≥ 33.7 ± 3.4 kg/m2 was obtained. Significant linear relationships between BMI and plasma fasting glucose, triglyceride, cholesterol, HDL cholesterol, sBP, or dBP were not observed in the women with a BMI > 35 kg/m2.
Results— Compared with lean (BMI <27) women of similar age, the morbidly obese patients appear to be at a higher risk for CHD. This is suggested by statistically significant increases in fasting insulin (mean ± SD; 187 ± 137 vs. 64.2 ± 16.2 pM) and triglyceride levels (128 ± 78.1 vs. 73 ± 25 mg/dl), sBP (132 ± 114 vs. 104 ± 15.8) and dBP (84 ± 72 vs. 67 ± 2.1 mmHg), and decreases in HDL cholesterol (1.03 ± 0.44 vs. 1.29 ± 0.82 mM) and apo A-I (91 ± 55 vs. 122 ± 35 mg/dl) concentrations.
Conclusions— It appears that there may be a threshold of body mass up to which insulin sensitivity is associated with CHD risk. Above this threshold, there does not appear to be a progressive increase in the risk factors for CHD with increases in BMI.
Publisher
American Diabetes Association
Subject
Advanced and Specialized Nursing,Endocrinology, Diabetes and Metabolism,Internal Medicine
Cited by
27 articles.
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