Prevalence of no insulin-resistance in morbidly obese patients
Diego Fernandez-Garcia, Jose Manuel Garcia Almeida, Arántzazu Sebastián-Ochoa & Francisco Tinahones Madueño
Progression of metabolic syndrome to diabetes is not easily predicted in patients with morbid obesity. We hypothesized that no insulin-resistance is more usual as we thought.
Objective: Evaluate prevalence of no insulin-resistance status in patients with morbid obesity.
Patients and method: The study was undertaken in 130 patients with a BMI of 53.93±6.67 kg/m2. The morbidly obese patients were divided into four groups: patients without insulin-resistance (MO-nonIR); morbidly obese patients with insulin resistance and without IGT or T2DM (MO-IR); patients with IGT (MO-IGT) and finally morbidly obese patients with T2DM (MO-DM). We determined anthropometrics parameters, serum glucose, cholesterol, HDL-cholesterol, triglycerides, CRP insulin, leptin, adiponectin and HOMA IR.
Results: Twenty-four patients had no criteria for insulin-resistance (18%). The MO-IR patients had significantly higher waist perimeter (P< 0.01) and systolic blood pressure (P<0.04) than MO-nonIR. The MO-IR patients also had significantly higher levels of CRP (P<0.05), triglycerides (P<0.002), VLDL-cholesterol (P<0.01) and circulating GGT (P<0.001) in comparison with the MO-nonIR. Additionally, the MO-IR had significantly higher serum glucose (P<0.002) and insulin levels (P<0.001) in comparison with the MO-nonIR. Finally, the MO-IR patients had significantly lower circulating adiponectin levels (P=0.05). In MO-IR group, HOMA IR correlated positively with weight (r:0.19; P:0.1), waist circunference (r:0.22; P:0.01), glucose serum levels (r:0.19; P:0.01), triglycerides (r:0.12; P:0.02), GOT (r:0.15; P:0.03), GPT (r:0.21; P:0.01), GGT (r:0.17; P: 0.04) and CRP (r:0.2; P:0.04). In addition, HOMA IR correlated negatively with HDL (r:−0.26; P:0.001). Using stratified HOMA status, a significant relation was found with age, FFA, glucose, TG, LDL, VLDL and GGT.
Conclusion: This transversal study shows the prevalence of insulin-resistance in patients with severe morbid obesity and clinical and biochemical factors related with this condition.