OBESITY TYPE AND CLUSTERING OF INSULIN RESISTANCE-ASSOCIATED CARDIOVASCULAR RISK-FACTORS IN MIDDLE-AGED MEN AND WOMEN

OBJECTIVE: To examine different clusterings of the insulin resistance- associated cardiovascular risk factors with respect to different types of obesity. DESIGN: A screening programme for obesity (body mass inde x; BMI greater than or equal to 30 kg/m(2)) and abdominal adiposity (w aist-to-hip ratio; WHR greater than or equal to 1.00 in men and greate r than or equal to 0.88 in women). SETTINGS: Pieksamaki District Healt h Centre and the Community Health Centre of the City of Tampere, Finla nd. SUBJECTS: All volunteers were either aged 36, 41, 46 or 51 y (n = 1148) and living in the town of Pieksamaki, with a control population of 162 subjects in the City of Tampere. MAIN OUTCOME MEASURES: Differe nt clusterings of: 1) hypertension (a systolic blood pressure greater than or equal to 160 mmHg and/or diastolic blood pressure greater than or equal to 95 mmHg or concurrent drug treatment for hypertension); 2 ) hypertriglyceridaemia greater than or equal to 1.70 mmol/l; 3) a low level of high-density-lipoprotein (HDL) cholesterol; < 1.00 mmol/l in men, < 1.20 mmol/l in women; 4) abnormal glucose metabolism (impaired glucose tolerance or non-insulin-dependent diabetes) and 5) hyperinsu linaemia with a fasting plasma insulin greater than or equal to 13.0 m U/l. RESULTS: The prevalence of a cluster consisting of dyslipidaemia (hypertriglyceridaemia and/or low HDL-cholesterol) and insulin resista nce (abnormal glucose metabolism and/or hyperinsulinaemia) was found t o be 4% in the control subjects, 18% in the abdominal adipose subjects (WHR greater than or equal to 1.00 in men and greater than or equal t o 0.88 in women with a BMI < 30 kg/m(2)), 28% in the 'pure' obese subj ects (BMI greater than or equal to 30 kg/m(2) with WHR < 1.00 in men a nd < 0.88 in women), and 46% in the central obese subjects (subjects s howing both 'pure' obesity and abdominal adiposity). The prevalence ra tes of the other clusterings of abnormalities varied similarly accordi ng to the type of obesity. CONCLUSION: Clusterings of insulin resistan ce-associated abnormalities were related to the type of obesity in bot h middle-aged men and middle-aged women.