Abstract
The metabolic syndrome mostly represented by obesity and hyperinsulinaemia connected with insulin resistance, presents the main mechanism in the pathogenesis of cardiovascular disease. The aim of this study was to analyze the interrelations between several metabolic variables (including leptin) and factors related to insulin resistance in groups of both normal and non-diabetic hyperlipemic postmenopausal women and men of appropriate age, and to attempt to elucidate the gender differences. Two groups of patients (20 men, 20 women) with hypertriglyceridemia were compared with 30 individuals (10 men, 20 women) with normal serum triacylglycerols. Fasting serum leptin concentration, lipid parameters (triacylglycerols, HDL cholesterol, LDL cholesterol) and BMI were measured and compared with changes in insulin parameters influencing insulin resistance (HOMA IR, insulin, intact proinsulin, C-peptide). Statistical analysis was performed using SAS/STAT software including unpaired Student's t-test, Kolmogorov-Smirnov's test, Spearman's rank-order correlation and multiple regression analysis. In men, the insulin sensitivity correlates with leptin only. In women insulin sensitivity is markedly influenced by a complex of factors: leptin and lipid parameters. Increased insulin resistance in men is followed mainly by the increased correlations between leptin, HOMA IR and insulin parameters. In women correlations between leptin, HOMA IR and insulin parameters were smaller, but the inverse correlation with HDL cholesterol was stronger. In postmenopausal women and also in men, serum leptin concentration contributes to insulin resistance. However in women the effect of increase in serum triacylglycerols in contribution of insulin resistance seems to be more dominant.
Highlights
The metabolic syndrome (Reaven’s syndrome) mostly represented by obesity and hyperinsulinaemia connected with insulin resistance, presents the main mechanism in the pathogenesis of cardiovascular disease
All parameters related to insulin resistance were typically changed in the test group of men
In men leptin is a dominant factor and together with the decrease in HDL cholesterol it can influence the degree of insulin resistance and together with the increase in serum triacylglycerols it can participate in release of insulin from endogenous pancreas
Summary
The metabolic syndrome (Reaven’s syndrome) mostly represented by obesity and hyperinsulinaemia connected with insulin resistance, presents the main mechanism in the pathogenesis of cardiovascular disease. The prevalence of this metabolic disorder constantly increases in connection with the pandemia of obesity and insulin resistance. Noted components appear in younger individuals even in children[24, 30]. More than every third adult human suffers from this syndrome. Single factors of the metabolic syndrome hang together and influence each other. The effect does not add up, but instead multiplies and increases the risk of cardiovascular morbidity and mortality13,18, . The effect does not add up, but instead multiplies and increases the risk of cardiovascular morbidity and mortality13,18, . 24,25
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