FASTING SERUM-INSULIN IN RELATION TO COMPONENTS OF THE METABOLIC-SYNDROME IN EUROPEAN HEALTHY-MEN - THE EUROPEAN FAT DISTRIBUTION STUDY

To investigate the ''metabolic'' syndrome in different European popula tions, samples of 38-year-old healthy men were randomly selected from six centers: Gothenburg (Sweden), Warsaw (Poland), Deinze (Belgium), V erona (Italy), Lumiar (Portugal), and Ede (The Netherlands). In total, 515 men were studied. Anthropometric measurements and blood pressure levels were taken by one or two operators in each center after a commo n operator's training course. Each blood parameter was analyzed in one laboratory. There were significant intercenter differences in mean va lues for anthropometric parameters, blood pressure, serum lipids (exce pt for low-density lipoprotein [LDL] cholesterol), and fasting insulin . In particular, fasting serum insulin showed the highest values in Sw eden and The Netherlands and the lowest values in Italy and Portugal. In pooled men, fasting insulin was strongly related (P < .001) to body mass index (BMI), waist to hip (WHR) and waist to thigh (WTR) circumf erence ratios, serum lipids (except for LDL cholesterol), and blood pr essure. On the contrary, there were relevant differences in the correl ation of insulin with serum lipids and blood pressure when the data we re evaluated for each center. However, generally both in each center a nd in all centers together all these correlations disappeared after ad justment for BMI, with the exception of the correlation with serum tri glycerides. In pooled men, multiple regression analysis showed an inde pendent association of fasting insulin, BMI, and WHR with serum trigly ceride (P < .001). On the contrary, total, LDL, and high-density lipop rotein (HDL) cholesterol and blood pressure values showed independent associations with BMI and/or WHR but not with fasting insulin in multi variate models. Thus, in conclusion, the metabolic syndrome is widely present in 38-year-old predominantly non-obese European men, but the m ost aggregating factor seems more likely to be obesity than hyperinsul inemia. In fact, obesity and abdominal fat distribution, rather than h yperinsulinemia, appear to be associated with an unfavorable risk prof ile (increased total cholesterol, decreased HDL cholesterol, and high blood pressure levels) for cardiovascular disease in these European me n. Copyright (C) 1995 by W.B. Saunders Company