Increasing insulin resistance contributes to worsening glycaemic and lipid profiles in older Chinese subjects

Abstract

Objective: To investigate the impact of insulin resistance on cardiovascular risk factors in the elderly. Research design and methods: A cross-sectional, community-based study of 225 older Chinese participants (65-74 years, 55.6% female) recruited from community centres for the elderly in Shatin. Anthropometric measures and DXA body fat, blood pressure, insulin sensitivity (fasting insulin, fasting insulin-glucose product, short insulin tolerance test (SITT)), glycaemic (fasting glucose, glycated haemoglobin A1c) and lipid (total, HDL-, and LDL-cholesterol, triglycerides) indices and albuminuria (24h albumin-to-creatinine ratio) were measured. Results: There was a close correlation between the SITT and insulin-glucose product indices of insulin resistance. Decreasing tertiles of insulin sensitivity were associated with increasing indices of glycaemic control, and general and central obesity, including DXA lean and fat mass, albuminuria, and triglycerides, with decreasing HDL-cholesterol. There were no differences in blood pressure or electrolyte levels between these tertile groups. These subjects were more insulin resistant than a group of younger diabetics. Conclusions: Insulin resistance was associated with indices of obesity and an atherogenic lipid and hyperglycaemic profile and may in part contribute to the high frequency of metabolic syndrome components in these older Chinese subjects. © 2003 Elsevier Ireland Ltd. All rights reserved.