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Insulin resistance is not necessarily an essential element of metabolic syndrome

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Abstract

Type 2 diabetes is frequently associated with metabolic syndrome (MetS). Insulin resistance (IR) is thought to be the underlying pathophysiology of MetS. The purpose of this study is to examine the association of MetS with IR and beta cell function. This is a cross-sectional study in NHANES 1999–2000 participants who were at least 18 years old, including 911 non-Hispanic whites (NHW), 398 non-Hispanic blacks (NHB), and 595 Mexican–Americans (MA). MetS was defined based on the revised ATP III. IR and beta cell function were calculated using homeostasis model assessment (HOMA-IR and HOMA-B). The high-risk tertile was defined as the highest HOMA-IR and lowest HOMA-B. The odds ratio (OR) was calculated against the other two tertiles. The relationship of HOAM-IR and HOMA-B with the components of MetS was also examined. IR was a risk factor of MetS in all three ethnic groups (OR 4.17–12.01, P < 0.0001). Fasting glucose, triglycerides, and HDL cholesterol were associated with IR (P < 0.001) and correlated with HOMA-IR (P < 0.001), while inconsistent results were noted in blood pressure and waist circumference among three racial/ethnic groups. However, in the MetS subjects, 32 % of NHW, 28 % of NHB, and 44 % of MA were not in the IR tertile and in the IR subjects, 25 % of NHW, 36 % NHB, and 30 % of MA did not have MetS. No relationship was found between beta cell function and MetS. Although IR is a risk factor for MetS, IR is neither necessary nor required for MetS.

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Abbreviations

ATP III:

Adult Treatment Panel III report

CI:

Confidence intervals

CVD:

Cardiovascular disease

HOMA-B:

Beta cell function by homeostasis model assessment

HOMA-IR:

Insulin resistance by homeostasis model assessment

IR:

Insulin resistance

MA:

Mexican–American

MetS:

Metabolic syndrome

NHANES:

National Health and Nutrition Examination Survey

NHB:

Non-Hispanic black

NHW:

Non-Hispanic white

OR:

Odds ratio

T2DM:

Type 2 diabetes

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The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Department of Clinical Diabetes, Endocrinology, and Metabolism, City of Hope National Medical Center, 1500 E Duarte Road, Duarte, CA, 91010, USA

    Rudruidee Karnchanasorn & Ken C. Chiu

  2. Division of Endocrinology, Metabolism and Nutrition, Department of Internal Medicine, Harbor-UCLA Medical Center, Torrance, CA, USA

    Rudruidee Karnchanasorn & Ken C. Chiu

  3. Division of Endocrinology and Metabolism, Department of Internal Medicine, National Cheng-Kung University Medical College and Hospital, Tainan, Taiwan

    Horng-Yi Ou

  4. Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan

    Lee-Ming Chuang

  5. Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan

    Lee-Ming Chuang

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  1. Rudruidee Karnchanasorn
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Correspondence to Ken C. Chiu.

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Karnchanasorn, R., Ou, HY., Chuang, LM. et al. Insulin resistance is not necessarily an essential element of metabolic syndrome. Endocrine 43, 92–99 (2013). https://doi.org/10.1007/s12020-012-9702-3

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