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Relation of fasting plasma insulin concentration to high density lipoprotein cholesterol and triglyceride
A Laws1, A C King, W L Haskell
1Center for Research in Disease Prevention, Stanford University, Palo Alto, Calif.
Insights
Fasting insulin levels, not BMI or waist-to-hip ratio, are key predictors of low HDL cholesterol and high triglycerides in men. This finding highlights insulin resistance
Area of Science:
- Cardiovascular Health
- Metabolic Syndrome
- Lipid Metabolism
Background:
- Low high-density lipoprotein (HDL) cholesterol is a risk factor for coronary heart disease (CHD).
- Low HDL and high triglycerides are often linked to insulin resistance, obesity, and poor physical fitness.
- Identifying key predictors of these lipid abnormalities is crucial for cardiovascular risk assessment.
Purpose of the Study:
- To determine whether fasting plasma insulin, body mass index (BMI), or waist-to-hip ratio (WHR) best identifies men with low HDL cholesterol and high triglyceride concentrations.
- To assess the predictive value of insulin concentration, obesity, regional adiposity, and physical fitness on HDL and triglyceride levels.
Main Methods:
- 83 men aged 50-65, free of CHD or diabetes, were divided into tertiles based on BMI, WHR, or fasting plasma insulin.
- Statistical analysis, including forward stepwise regressions, was used to evaluate the relationship between variables.
- Maximal oxygen uptake (VO2max) was measured as an indicator of physical fitness.
Main Results:
- Only plasma insulin tertiles showed statistically significant differences in HDL cholesterol and triglyceride concentrations.
- Fasting insulin concentration, independent of BMI, WHR, or VO2max, significantly predicted HDL cholesterol (R2 = 0.07, p < 0.02) and triglyceride (R2 = 0.20, p < 0.001) levels.
- Neither BMI, WHR, nor VO2max independently predicted HDL cholesterol or triglyceride concentrations.
Conclusions:
- Plasma insulin concentration is a significant predictor of HDL cholesterol and triglyceride levels in middle-aged men.
- Insulin resistance, as indicated by plasma insulin, appears to be a more critical factor than general obesity or regional adiposity in determining these lipid abnormalities.
- These findings suggest that targeting insulin resistance may be important for managing dyslipidemia and reducing cardiovascular risk.
Abstract:
Low plasma high density lipoprotein (HDL) cholesterol concentration is a risk factor for coronary heart disease (CHD) and is frequently associated with high triglyceride concentration. Both of these abnormalities have been related to insulin resistance as estimated by plasma insulin concentrations and to measures of obesity, regional adiposity, and physical fitness. To determine which of these variables (fasting plasma insulin, obesity as measured by body mass index [BMI], or regional adiposity as measured by waist to hip ratio [WHR]) best identifies men with low HDL cholesterol and high triglyceride concentrations, we divided 83 men, aged 50-65 years, who were free of CHD or diabetes, into tertiles based on BMI, WHR, or fasting plasma insulin concentration. Only for plasma insulin tertiles were there statistically significant differences in HDL cholesterol (tertile 1, mean +/- SEM, 1.34 +/- 0.08 mmol/l; 2, 1.16 +/- 0.05 mmol/l; 3, 1.10 +/- 0.06 mmol/l; p less than 0.03) and triglyceride (tertile 1, 1.05 +/- 0.08 mmol/l; 2, 1.48 +/- 0.12 mmol/l; 3, 1.82 +/- 0.17 mmol/l; p less than 0.005) concentrations. In forward stepwise regressions with HDL cholesterol and triglyceride as dependent variables, fasting insulin concentration but not BMI, WHR, or maximal oxygen uptake (VO2max), a measure of physical fitness, predicted HDL cholesterol (R2 = 0.07, p less than 0.02) and triglyceride (R2 = 0.20, p less than 0.001) concentrations. The data suggest that plasma insulin concentration is an important predictor of HDL cholesterol and triglyceride concentrations independent of BMI, WHR, or VO2max.