Association between high-fasting insulin levels and metabolic syndrome in non-diabetic middle-aged and elderly populations: a community-based study in Taiwan.

Content Provider	Europe PMC
Author	Chen, Yun-Hung Lee, Yu-Chien Tsao, Yu-Chung Lu, Mei-Chun Chuang, Hai-Hua Yeh, Wei-Chung Tzeng, I-Shiang Chen, Jau-Yuan
Copyright Year	2018
Abstract	ObjectivesWe aimed to determine the association between fasting insulin (FI) levels and metabolic syndrome (MetS) in non-diabetic middle-aged and elderly adults in a community in Taiwan.DesignCross-sectional observational study.SettingCommunity-based investigation in Guishan township of northern Taiwan.ParticipantsOur study included adults aged 50 years and above during community health examinations between January and October 2014. People with diabetes mellitus were excluded. A total of 321 people were enrolled.Outcome measuresWe divided participants according to tertiles of FI as low, medium and high levels. Pearson correlation was assessed between insulin level and each of the diagnostic components of metabolic syndrome (MetS-DCs) with adjustment of age. The prevalence of MetS-DCs based on tertiles of FI were studied and analysed by Cochran–Armitage trend test. The risk for prevalence of MetS in the middle and high insulin group as compared with the low insulin group were assessed by multivariate logistic regression with adjustments for age, gender, smoking, body mass index (BMI), hypertension and hyperlipidaemia. Youden Index was performed for the optimised cut-off value.ResultsOur results showed positive correlation of FI level with systolic blood pressure, waist circumference, fasting plasma glucose and triglyceride levels, while negative correlation was shown with high-density lipoprotein (P<0.001). The prevalence of each MetS-DCs increased as a trend while FI levels increased (P<0.001). OR (95% CI) of MetS was 5.04 (2.15 to 11.81) for high insulin groups compared with the low insulin group after adjusting confounders (P<0.001). Area under receiver operating characteristic curve (ROC) curve (AUC) was 0.78, and cut-off value 7.35 μU/mL for FI was obtained (sensitivity: 0.69; specificity: 0.77).ConclusionsMiddle-aged and elderly non-diabetic people with increased FI are associated with a higher prevalence of MetS in the community in Taiwan. Furthermore, FI is an independent risk factor of MetS in this study population.
Journal	BMJ Open
Volume Number	8
PubMed Central reference number	PMC5942468
Issue Number	5
PubMed reference number	29724734
e-ISSN	20446055
DOI	10.1136/bmjopen-2017-016554
Language	English
Publisher	BMJ Publishing Group
Publisher Date	2018-05-03
Publisher Place	London
Access Restriction	Open
Rights License	This is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) license, which permits others to distribute, remix, adapt and build upon this work, for commercial use, provided the original work is properly cited. See: http://creativecommons.org/licenses/by/4.0/ © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
Subject Keyword	metabolic syndrome insulin resistance fasting insulin level
Content Type	Text
Resource Type	Article
Subject	Medicine