THE INSULIN-RESISTANCE SYNDROME IN MEXICO - PREVALENCE AND CLINICAL CHARACTERISTICS - A POPULATION-BASED STUDY

The insulin resistance syndrome (IRS) is recognized as a harbinger of serious morbidity and high mortality. No published data on the prevale nce of the IRS in the Mexican population exist. We estimated the preva lence of the IRS in an area that had 15,532 inhabitants, 3505 (22.6%) of whom were eligible (35-64 years of age, men and non-pregnant women) . Interviews were obtained on 2810 (80.2%), a physical and laboratory examination with oral glucose tolerance test, insulin determinations a nd lipid profile was performed on 2282 individuals, 81.2% of those int erviewed, 65.1% of eligibles. The IRS was defined as the coexistence o f the triad: hypertension, glucose intolerance (diabetes or impaired g lucose tolerance) and dyslipidemia (triglycerides >= 200 mg/dl and HDL <35 mg/dl). Using this diagnostic criteria the prevalence of IRS in t he general population was 2.97% for men and 3.21% for women. In subjec ts with impaired glucose tolerance (IGT), the IRS was identified in 11 .7%. In diabetics, IRS occurred in 13.7%. Subjects with IRS (IGT and d iabetics) were significantly more obese (BMI 30 +/- 4.3 vs. 28.4 +/- 4 .2 kg/m(2) p <0.001), had central upper body fat pattern distribution (sub/tri skinfolds 1.66 +/- 1.1 vs. 1.5 +/- 0.7 p <0.02), (waist/hip c ircumferences 1 +/- 0.07 vs. 0.97 +/- 0.07 p <0.001) and hyperinsuline mia fasting and post glucose load (25 +/- 17 vs. 15 +/- 13 p <0.001, 1 57 +/- 92 vs. 85 +/- 72 p <0.001, respectively). We conclude that the prevalence of IRS is high, individuals with IRS in Mexico have an anth ropometric profile characterized by central, upper body obesity. A sig nificant proportion of the patients with IGT and DM are at the highest cardiovascular risk.