Abstract
BackgroundIn most individuals, obesity and insulin resistance coexist. However, some individuals have excessive adipose tissue mass but remain insulin sensitive. Moreover, lean individuals can develop acute inflammation-induced insulin resistance, even without excess adipose tissue mass.ObjectiveOur aim was to compare inflammatory markers in overweight, insulin-sensitive and lean, insulin-resistant healthy subjects.MethodsA cross-sectional study with 1098 participants (CAMELIA project) was conducted in family doctor primary care program at Niteroi, RJ, Brazil. In the present substudy, we have selected non-obese healthy subjects (n = 203). Insulin resistance was defined by a homeostatic model assessment (HOMA-IR) >2.6, and overweight subject BMIs were 25< BMI <30 kg/m2. Associations were estimated through binary logistic regression with generalized estimation equation models.ResultsWe compared overweight, insulin-sensitive healthy individuals (n = 74) with a mean age of 39.2 ± 1.3 and lean, insulin-resistant healthy individuals (n = 18) with a mean age of 31.9 ± 3.6. C-reactive protein levels were positively correlated with body mass index in the lean, insulin-resistant group. In the multiple regression model, a positive association was observed with MCP-1 and IL-6 expression after adjustment for age, waist circumference, glycated hemoglobin, resistin, adiponectin, C-reactive protein and PAI-1 levels.ConclusionOur findings suggest that a lean, insulin-resistant subject may have higher pro-inflammatory marker levels (MCP-1, IL-6 and resistin) than an overweight, insulin-sensitive subject. This suggest an early risk phenotype that should further be investigated for possible prognostic implications.
Highlights
In most individuals, obesity and insulin resistance coexist
In the multiple regression model, a positive association was observed with monocyte chemotactic protein-1 (MCP-1) and IL-6 expression after adjustment for age, waist circumference, glycated hemoglobin, resistin, adiponectin, C-reactive protein and plasminogen activator inhibitor-1 (PAI-1) levels
Our findings suggest that a lean, insulin-resistant subject may have higher pro-inflammatory marker levels (MCP-1, IL-6 and resistin) than an overweight, insulin-sensitive subject
Summary
Some individuals have excessive adipose tissue mass but remain insulin sensitive. Lean individuals can develop acute inflammation-induced insulin resistance, even without excess adipose tissue mass. Epidemiologic studies have suggested a possible relationship between inflammation and insulin resistance [1]. This evidence has become robust and suggests that obesity and inflammation are the main components of insulin resistance [2, 3]. Lean subjects can develop inflammationassociated insulin resistance [6]
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