[The metabolic syndrome: its detection with the 50-gram glucose test]

Epidemiological evidence suggests that resistance to insulin is the common nexus of the accumulation of factors in patients at high cardiovascular risk. To find a test which enables resistance to insulin to be identified in large populations will allow preventive and therapeutic measures to be taken.

Crossover.

Carrascosa del Campo and Cuenca Health Centres.

408 patients (154 men and 254 women), all the non-diabetic obese patients at the two health centres, were studied.

Levels of cholesterol, triglycerides and uric acid were measured. Patients were medically examined, and blood pressure, waist and hip measurements, toxic habits and cardiovascular history were found. They were classified by pathology and normograms. The O'Sullivan and microalbuminuria tests were performed, and all the statistical associations with biochemical and medical characteristics were studied. The O'Sullivan test was significantly associated (p < 0.01) with cardiovascular risk and insulin-resistance factors such as hypercholesterolaemia (RR 1.63), hypertension (RR 1.92), hypertriglyceridaemia (RR 2.47), hyperuricaemia (RR 1.80), with the Berglund resistance index (RR 1.52) and the microalbuminuria test (RR 1.83). The association was more consistent when there were a number of factors combining. There was no relationship with the waist/hip index found.

The O'Sullivan test, on its own or with the microalbuminuria test, seems very useful for identifying obese subjects with resistance to insulin.