Lean insulin-resistant young adults display increased cardiometabolic risk: A retrospective cross-sectional study

Katarína Šebeková; Radana Gurecká; Melinda Csongová; Ivana Koborová; Gabriela Repiská; Ľudmila Podracká

doi:10.1016/j.diabres.2022.109217

Lean insulin-resistant young adults display increased cardiometabolic risk: A retrospective cross-sectional study

Diabetes Res Clin Pract. 2022 Mar:185:109217. doi: 10.1016/j.diabres.2022.109217. Epub 2022 Feb 1.

Authors

Katarína Šebeková¹, Radana Gurecká², Melinda Csongová³, Ivana Koborová³, Gabriela Repiská⁴, Ľudmila Podracká⁵

Affiliations

¹ Institute of Molecular Biomedicine, Faculty of Medicine, Comenius University, Bratislava, Slovakia. Electronic address: katarina.sebekova@imbm.sk.
² Institute of Molecular Biomedicine, Faculty of Medicine, Comenius University, Bratislava, Slovakia; Institute of Medical Physics, Biophysics, Informatics and Telemedicine, Faculty of Medicine, Comenius University, Bratislava, Slovakia.
³ Institute of Molecular Biomedicine, Faculty of Medicine, Comenius University, Bratislava, Slovakia.
⁴ Institute of Physiology, Comenius University, Bratislava, Slovakia.
⁵ Department of Pediatrics of the Faculty of Medicine, Comenius University, and of The National Institute of Children's Health, Bratislava, Slovakia.

PMID: 35114297
DOI: 10.1016/j.diabres.2022.109217

Abstract

Aim: We investigated whether lean insulin-resistant individuals manifest increased cardiometabolic risk.

Methods: 2,341 (51.8% females) healthy 16-23-year-old subjects were categorized as lean or overweight/obese; and insulin-sensitive or insulin-resistant, and compared.

Results: In both sexes, lean insulin-sensitive and insulin-resistant subjects displayed similar measures of obesity (e.g., males, waist-to-height ratio: lean insulin-sensitive: 0.42 ± 0.03, lean insulin-resistant: 0.43 ± 0.03, overweight/obese insulin-sensitive: 0.49 ± 0.05, overweight/obese insulin-resistant: 0.53 ± 0.06). Lean insulin-sensitive individuals were more insulin-sensitive compared with their overweight/obese peers; insulin-resistant groups presented similar insulin-sensitivity (males, the Quantitative insulin-sensitivity check index (QUICKI): lean insulin-sensitive: 0.354 ± 0.022, lean insulin-resistant: 0.304 ± 0.013, overweight/obese insulin-sensitive: 0.343 ± 0.019, overweight/obese insulin-resistant: 0.299 ± 0.015). The two-factor analysis of variance indicated an independent effect of insulin sensitivity, overweight/obesity, and their interaction on the continuous metabolic syndrome score (p < 0.001, all; males, lean insulin-sensitive: 1.87 ± 0.35, lean insulin-resistant: 2.14 ± 0.42, overweight/obese insulin-sensitive: 2.15 ± 0.40, overweight/obese insulin-resistant: 2.75 ± 0.69). C-reactive protein, leukocyte count, and glomerular filtration rate in both sexes; uric acid, asymmetric dimethyl-arginine, and soluble vascular adhesion protein-1 in males; and soluble receptor for advanced glycation end-products in females were independently associated with insulin resistance. Among phenotypes associated with low QUICKI, the distribution of insulin-resistant individuals was random.

Conclusion: Later clinical consequences of insulin resistance in lean subjects remain to be elucidated in longitudinal studies.

Keywords: ADMA; CRP; Continuous metabolic syndrome score; Insulin-resistance; eGFR; sRAGE; sVAP-1.

MeSH terms

Body Mass Index
Cardiovascular Diseases* / epidemiology
Cardiovascular Diseases* / etiology
Cross-Sectional Studies
Female
Humans
Insulin
Insulin Resistance*
Insulin, Regular, Human
Male
Obesity
Overweight
Receptor for Advanced Glycation End Products
Retrospective Studies
Young Adult

Substances

Insulin
Insulin, Regular, Human
Receptor for Advanced Glycation End Products