Subscribe to RSS
DOI: 10.1055/s-2002-34788
Obesity and Weight Gain Are Associated with Increased Incidence of Hyperinsulinemia in Non-Diabetic Men
Publication History
Received: 18 September 2001
Accepted after revision: 23 April 2002
Publication Date:
17 October 2002 (online)
Abstract
We investigated the temporal relationships between obesity, weight change and hyperinsulinemia in a population-based 4-year follow-up study of 695 middle-aged, non-diabetic, and normoinsulinemic men. Thirty-eight men developed hyperinsulinemia during the follow-up (fasting serum insulin ≥ 12.0 mU/l). In logistic regression analysis adjusting for other risk factors, men with body mass index of ≥ 26.7 kg/m2 (highest third) had a 6.6-fold (p = 0.001) risk of developing hyperinsulinemia, compared with men with body mass index of < 24.4 kg/m2 (lowest third). Correspondingly, men with waist-to-hip ratio of ≥ 0.95 (highest third) had a 3.5-fold (p = 0.028) incidence of hyperinsulinemia compared with men with waist-to-hip ratio of < 0.90 (lowest third). Weight gain in middle age and weight gain from the age of 20 years to middle age were also associated with increased risk of hyperinsulinemia. Hyperinsulinemia at baseline was not associated with weight gain during the follow-up. This prospective population-based study emphasizes the importance of avoiding obesity and weight gain during adulthood in preventing hyperinsulinemia.
Key words
Obesity - Weight Gain - Hyperinsulinemia - Insulin Resistance - Population Studies - Cohort Study
References
- 1 Després J-P, Marette A. Obesity and insulin resistance. Epidemiologic, metabolic, and molecular aspects. In: Reaven GM, Laws A (eds). Insulin resistance. The metabolic syndrome X Humana Press Totowa, New Jersey; 1999: 51-81
- 2 Swinburn B A, Nyomba B L, Saad M F, Zurlo F, Raz I, Knowler W C, Lillioja S, Bogardus C, Ravussin E. Insulin resistance associated with lower rates of weight gain in Pima Indians. J Clin Invest. 1991; 88 168-173
- 3 Schwartz M W, Boyko E J, Kahn S E, Ravussin E, Bogardus C. Reduced insulin secretion: an independent predictor of body weight gain. J Clin Endocrinol Metab. 1995; 80 1571-1576
- 4 Valdez R, Mitchell B D, Haffner S M, Hazuda H P, Morales P A, Monterrosa A, Stern M P. Predictors of weight change in a bi-ethnic population. The San Antonio Heart Study. Int J Obes Relat Metab Disord. 1994; 18 85-91
- 5 Hoag S, Marshall J A, Jones R H, Hamman R F. High fasting insulin levels associated with lower rates of weight gain in persons with glucose tolerance: the San Luis Valley Diabetes Study. Int J Obes Relat Metab Disord. 1995; 19 175-180
- 6 Yost T J, Jensen D R, Eckel R H. Weight regain following sustained weight reduction is predicted by relative insulin sensitivity. Obes Res. 1995; 3 583-587
- 7 Hodge A M, Dowse G K, Alberti K G, Tuomilehto J, Gareeboo H, Zimmet P Z. Relationship of insulin resistance to weight gain in non-diabetic Asian Indian, Creole, and Chinese Mauritians. Mauritius Non-communicable Disease Study Group. Metabolism. 1996; 45 627-633
- 8 Folsom A R, Vitelli L L, Lewis C E, Schreiner P J, Watson R L, Wagenknecht L E. Is fasting insulin concentration inversely associated with rate of weight gain? Contrasting findings from the CARDIA and ARIC study cohorts. Int J Obes Relat Metab Disord. 1998; 22 48-54
- 9 Odeleye O E, de Courten M, Pettitt D J, Ravussin E. Fasting hyperinsulinemia is a predictor of increased body weight gain and obesity in Pima Indian children. Diabetes. 1997; 46 1341-1345
- 10 Saad M F, Knowler W C, Pettitt D J, Nelson R G, Mott D M, Bennett P H. Sequential changes in serum insulin concentration during development of non-insulin-dependent diabetes. Lancet. 1989; 1 1356-1359
- 11 Wing R R, Matthews K A, Kuller L H, Smith D, Becker D, Plantinga P L, Meilahn E N. Environmental and familial contributions to insulin levels and change in insulin levels in middle-aged women. JAMA. 1992; 268 1890-1895
- 12 Folsom A R, Jacobs D R, Wagenknecht L E, Winkhart S P, Yunis C, Hilner J E, Savage P J, Smith D E, Flack J M. Increase in fasting insulin and glucose over seven years with increasing weight and inactivity of young adults. The CARDIA Study. Am J Epidemiol. 1996; 144 235-246
- 13 Srinivasan S R, Myers L, Berenson G S. Temporal association between obesity and hyperinsulinemia in children, adolescents, and young adults: the Bogalusa Heart Study. Metabolism. 1999; 48 928-934
- 14 Eckel R H. Insulin resistance: an adaptation for weight maintenance. Lancet. 1992; 340 1452-1453
- 15 Porte D, Seeley R J, Woods S C, Baskin D G, Figlewicz D P, Schwartz M W. Obesity, diabetes and the central nervous system. Diabetologia. 1998; 41 863-881
- 16 Kahn B B, Flier J S. Obesity and insulin resistance. J Clin Invest. 2000; 106 473-481
- 17 Salonen J T. Is there a continuing need for longitudinal epidemiologic research? The Kuopio Ischaemic Heart Disease Risk Factor Study. Ann Clin Res. 1988; 20 46-50
- 18 Salonen J T, Lakka T A, Lakka H-M, Valkonen V-P, Everson S A, Kaplan G A. Hyperinsulinemia is associated with the incidence of hypertension and dyslipidaemia in middle-aged men. Diabetes. 1998; 47 270-275
- 19 Everson S A, Goldberg D E, Helmrich S P, Lakka T A, Lynch J W, Kaplan G A, Salonen J T. Weight gain and the risk of developing insulin resistance syndrome. Diabetes Care. 1998; 21 1637-1643
- 20 Lakka H-M, Lakka T A, Tuomilehto J, Sivenius J, Salonen J T. Hyperinsulinemia and the risk of cardiovascular death and acute coronary and cerebrovascular events in men. Arch Intern Med. 2000; 160 1160-1168
- 21 Salonen J T, Salonen R, Seppänen K, Rauramaa R, Tuomi-lehto J. High density lipoprotein, HDL2 and HDL3 subfractions and the risk of acute myocardial infarction: a prospective population study in Eastern Finnish men. Circulation. 1991; 84 129-139
- 22 Salonen J T, Nyyssönen K, Tuomainen T-P, Mäenpää P H, Korpela H, Kaplan G A, Lynch J, Helmrich S, Salonen R. Increased risk of non-insulin-dependent diabetes mellitus at low plasma vitamin E concentrations: a four year follow up study in men. BMJ. 1995; 311 1124-1127
- 23 Salonen J T, Nyyssönen K, Korpela H, Tuomilehto J, Seppänen R, Salonen R. High stored iron levels are associated with excess risk of myocardial infarction in eastern Finnish men. Circulation. 1992; 86 803-811
- 24 Lakka T A, Venäläinen J M, Rauramaa R, Salonen R, Tuomilehto J, Salonen J T. Relation of leisure-time physical activity to the risk of acute myocardial infarction in men. N Engl J Med. 1994; 330 1549-1554
- 25 Lynch J L, Helmrich S P, Lakka T A, Kaplan G A, Cohen R D, Salonen R, Salonen J T. Moderately intense physical activities and high levels of cardiorespiratory fitness reduce the risk of non-insulin-dependent diabetes mellitus in middle-aged men. Arch Intern Med. 1996; 156 1307-1314
- 26 Neel J V. Diabetes mellitus: A “thrifty” genotype rendered detrimental by “progress”?. Am J Hum Genet. 1962; 14 353-362
- 27 Ravussin E, Gautier J F. Metabolic predictors of weight gain. Int J Obes Relat Metab Disord. 1999; 23 (Suppl. 1) 37-41
- 28 Lazarus R, Sparrow D, Weiss S. Temporal relations between obesity and insulin: longitudinal data from the Normative Aging Study. Am J Epidemiol. 1998; 147 173-179
- 29 Björntorp P. “Portal” adipose tissue as a generator of risk factors for cardiovascular disease and diabetes. Arteriosclerosis. 1990; 10 493-496
- 30 Bonadonna R C, Bonora E. Glucose and free fatty acid metabolism in human obesity. Relationships to insulin resistance. Diabetes Rev. 1997; 5 21-51
- 31 Carey D GP. Abdominal obesity. Curr Opin Lipidol. 1998; 9 35-40
- 32 Montague C T, O’Rahilly S. The perils of portliness: causes and consequences of visceral adiposity. Diabetes. 2000; 49 883-888
- 33 Lawrence V J, Coppack S W. The endocrine function of the fat cell-regulation by the sympathetic nervous system. Horm Metab Res. 2000; 32 453-467
- 34 Engeli S, Sharma A M. Role of adipose tissue for cardiovascular-renal regulation in health and disease. Horm Metab Res. 2000; 32 485-499
- 35 Garg A. The role of body fat distribution in insulin resistance. In: Reaven GM, Laws A (eds) Insulin resistance. The metabolic syndrome X. Humana Press Totowa, New Jersey; 1999: 83-96
- 36 Campbell L V, Carey D G, Chisholm D J. Measurement of central adiposity. A bet each way? Diabetes Care. 1996; 19 1033-1034
- 37 Abate N, Garg A, Peshock R M, Stray-Gundersen J, Grundy S M. Relationships of generalized and regional adiposity to insulin sensitivity in men. J Clin Invest. 1995; 96 88-98
- 38 Seidell J C, Bouchard C. Visceral fat in relation to health: is it a major culprit or simply an innocent bystander?. Int J Obes Relat Metab Disord. 1997; 21 626-631
-
39 World Health Organization .Obesity: Preventing and managing the global epidemic. Report of a WHO consultation.
WHO Technical Report Series, 894. World Health Organization Geneva, Switzerland; 2000 - 40 . Executive summary of the clinical guidelines on the identification, evaluation, and treatment of overweight and obesity in adults. Arch Intern Med. 1998; 158 1855-1867
- 41 Williams S RP, Jones E, Bell W, Davies B, Bourne M W. Body habitus and coronary heart disease in men. A review with reference to methods of body habitus assessment. Eur Heart J. 1997; 18 376-393
- 42 Laakso M. How good a marker is insulin level for insulin resistance?. Am J Epidemiol. 1993; 137 959-965
H.-M. Lakka, M.D., Ph.D.
Human Genomics Laboratory, Pennington Biomedical Research Center ·
Louisiana State University · 6400 Perkins Road, Baton Rouge · Louisiana 70808-4124 · USA
Phone: + 1 (225) 763 2631
Fax: + 1 (225) 763 3166
Email: lakkah@pbrc.edu