CARDIOVASCULAR RISK-FACTORS AND HYPERINSULINEMIA IN ELDERLY MEN - THEHONOLULU HEART PROGRAM

Associations of cardiovascular risk factors, including several measure s of adiposity, with hyperinsulinemia were assessed in 3562 elderly (7 1 to 93 years of age) Japanese American men from the Honolulu Heart Pr ogram who were examined between 1991 and 1993. In addition, cardiovasc ular risk factors measured 25 years earlier were also examined in rela tion Co hyperinsulinemia. Hyperinsulinemia was defined as fasting insu lin greater than or equal to 95th Percentile (20 mu U/mL) among the su bset of subjects (n = 504) who were nonobese and free of clinical diab etes and glucose intolerance. When this definition was applied to the entire population, the prevalence of hyperinsulinemia declined cross-s ectionally with age (P < 0.001) from 24.2% in men aged 71 to 74 years to 16.4% in men aged 85 Co 93 years. Factors having a positive and ind ependent association with hyperinsulinemia included body mass index (B MI), triglycerides, glucose, hematocrit, use of diabetic medication, h eart rate, and hypertension. The association with physical activity wa s negative. Triglycerides, BMI, diabetic medication, hypertension, and smoking levels measured 25 years earlier were also associated indepen dently with hyperinsulinemia. Associations were similar in nondiabetic subjects. Three measures of adiposity (BMI, waist circumference, and subscapular skinfold thickness) were independently related to hyperins ulinemia cross-sectionally. However, associations involving a differen ce between the 80th and 20th percentiles in each adiposity measure app eared strongest for BMI (odds ratio (OR) = 4.5, 95% confidence interva l (CI) = 3.7 to 5.6) and waist circumference (OR = 4.1, 95% CI = 3.3-5 .1) and slightly weaker for subscapular skinfold thickness (OR = 2.1, 95% CI = 1.8-2.5). These findings suggest that features of an insulin resistance syndrome including dyslipidemia, glucose intolerance, hyper tension, and obesity, assessed both cross-sectionally and 25 years pre viously, are associated independently with hyperinsulinemia in elderly Japanese American men. (C) 1996 by Elsevier Science Inc.