Relationships Between Insulin Resistance, Central Obesity And Multifactorial Intervention

Background and objectives:Metabolic Syndrome(MS) is a clustering of multiple cardiovascular risk factors, such as central obesity, hypertension,and various metabolic disorders.Insulin resistance(IR) was considered to be a pathway of these diseases. However ,recent researches reveal that central obesity also plays an important role in the development of IR and MS.The prevalence of hypertension,diabetes mellitus(DM) and MS is growing rapidly. Multifactorial intervention is recommended as a common treatment plan of these diseases,but its results are affected by many agents.This study aims to investigate the relationships between obesity ,IR and the multifactorial intervention in order to improve the control rate of cardiovascular risk factors.Subjects and Methods:1. SubjectsThe study was conducted among patients admitted to hospital by initial diagnoses of diabetes mellitus(DM), hypertension or MS. 490 patients completed all the rechecks after an average following period of 9 (7-14)months.The average age was 59.5±11.5 years. MS was diagnosed by modified NCEP-ATP III criteria. DM was defined according to the criteria of ADA(1997). Hypertesion was defined according to the criteria of WHO/ISH (1999). IR was assessed by the Homeostasis Model Assessment (HOMA),according to the formula HOMA-IR=FPG(mmol/L)×fasting insulin(mIU/ml)/22.5.The subjects of the first part included 345 patients who had fasting insulin checked before intervention.They were divided into two groups as group of IR and group of insulin sensitity(IS) according to the HOMA-IR before intervention.The subjects of the second part include all of the 490 patients.According to the change of waist circumference(WC), 490 patients were divided into two groups respectively with decreasing WC and increasing WC.2. Intervention measures and data collectionLifestyle modification included smoke quiting,proper diet and physical...