Insulin Resistance in relation to Hypertension and Dyslipidaemia among Men Clinically Diagnosed with Type 2 Diabetes

Abstract

Pathophysiologically, type 2 diabetes can result from insulin resistance or insulin insufficiency alone. It is unclear whether relative insulin shortage or pronounced insulin resistance is linked to poor cardiometabolic problems like obesity. Therefore, the objective of this study was to evaluate the relationship between insulin resistance (IR), hypertension, and dyslipidaemia, in men with type 2 diabetes mellitus. One hundred and twenty-one (121) type 2 diabetic men participated in this cross-sectional study, which was conducted between September 2018 and September 2019. Sociodemographic information was collected using a self-designed questionnaire. Anthropometric data were also taken and blood samples collected for estimation of insulin, glucose, and lipid concentrations. HOMA-IR was calculated from the fasting insulin and glucose values, and a $\text{HOMA}-\text{IR}\ge 2$ was considered to indicate insulin resistance. Of the 121 participants, 39.7% were classified as insulin-resistant. Levels of total cholesterol ( $4.82\pm 1.2$  mmol/L; $p=0.007$ vs. $4.25\pm 1.1$  mmol/L), LDL cholesterol ( $3.17\pm 0.9$  mmol/L; $p=0.001$ vs. $2.52\pm 0.8$  mmol/L), and TC/HDL-C ratio ( $3.93\pm 0.9$ ; $p=0.042$ vs. $3.58\pm 0.9$ ) and the prevalence of abnormal LDL-C (14.6%; $p=0.015$ vs. 2.7%) and elevated BP (83.3%; $p=0.048$ vs. 67.1%) were higher in the insulin-resistant group. LDL cholesterol ( $\text{AUC}=0.670$ ; $p=0.001$ ) better classified subjects as being insulin-resistant compared to other lipid markers. The odds of insulin resistance in dyslipidaemia were not statistically significant after adjusting for obesity. The link between insulin resistance and dyslipidaemia and hypertension in male diabetics may thus be mediated by obesity.