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2013, Number 2

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Rev Cuba Endoc 2013; 24 (2)

Association of the insulin resistance with the cardiovascular risk in overweight and obese persons, according to several cardiovascular risk tables and risk factors

Cabrera RCE, Cálix IWD, Stusser IBI, Parlá SJ, Álvarez ÁA, Olano JR, Rodríguez AJ, Reyes RAD, Armas RNB

Language: Spanish
References: 58
Page: 136-152
PDF size: 108.07 Kb.


ABSTRACT

Objective: to determine the cardiovascular risk and risk factor table that is most associated with the insulin resistance in overweight and obese patients.
Methods: three hundred fifty overweight and obese patients, aged 19 to 70 years, were studied. They were questioned about age, sex, race, toxic habits, physical exercising and pharmaceutical consumption. The details of the physical exam included weight, size, body mass index, blood pressure, waist and hip circumference, waist-hip index. The biochemical exams were glucose, insulin, cholesterol, triglycerides and HDL-C on fasting. Mathews' homeostatic model estimation index served to evaluate the insulin resistance. The WHO table, the Framingham table and Gaziano table sere used to measure the cardiovascular risk.
Results: the comparison of the cardiovascular risk frequency according to the tables showed that the moderate and the high risks in Gaziano table were higher than those of the Framingham and of the World Health Organization (20.6 % [72/350] vs. 2.9 % [10/350] and 3.7 % [13/350]). The insulin resistance frequency was similar in all the cardiovascular risk tables. In the analysis of the relations between the insulin resistance and each cardiovascular risk factor, increased triglyceride indexes prevailed (68.7 %) followed by cholesterol index of ≥ 5.2 mmol/L (60.2 %), body mass index of ≥ 30 (59.0 %) and hypertension (59,5 %). The sensitivity of detection of insulin resistance observed in each cardiovascular risk table was similar; however, Gaziano tables showed higher specificity (43 %). As to the sensitivity and specificity of the insulin resistance for each cardiovascular risk factor, the body mass index of ≥ 30 yielded the highest specificity (74.5 %).
Conclusions: it is advisable to use Gaziano tables because they detected a higher number of individuals with cardiovascular risks, in addition to their higher specificity to detect subjects with insulin resistance. Obesity and hypertriglyceridemia were the cardiovascular risk factors most associated to the insulin resistance, so they should be taken into account to start therapeutic intervention in order to prevent the onset of some cardiovascular diseases.


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