Am J Epidemiol 2003; 158:1058-1067.
Copyright © 2003 by the Johns
Hopkins Bloomberg School of Public Health
ORIGINAL CONTRIBUTIONS |
Risk Factors for Progression to Incident Hyperinsulinemia: The Atherosclerosis Risk in Communities Study, 1987–1998
1 Stanford Center for Research in Disease Prevention, Stanford University School of Medicine, Palo Alto, CA.
2 Current affiliation: Department of Preventive Medicine, The Feinberg School of Medicine, Northwestern University, Chicago, IL.
3 Department of Social Medicine, School of Medicine, Federal University of Rio Grande do Sul, Porto Alegre, Brazil.
4 Department of Biostatistics, School of Public Health, University of North Carolina, Chapel Hill, Chapel Hill, NC.
Hyperinsulinemia is a marker of insulin resistance, a correlate of the metabolic syndrome, and an established precursor of type 2 diabetes. This US study investigated the role of risk factors associated with hyperinsulinemia in cross-sectional studies in progression to incident hyperinsulinemia. Nondiabetic participants from the Atherosclerosis Risk in Communities Study (n = 9,020) were followed from 1987 to 1998 for the development of hyperinsulinemia (fasting serum insulin 
90th percentile, 19.1 µU/ml). After adjustment for demographic characteristics, all risk factors simultaneously, and baseline insulin value, the risk of progressing to hyperinsulinemia increased per standard deviation increase in baseline uric acid (odds ratio (OR) = 1.3, 95% confidence interval (CI): 1.2, 1.4; per 1.4 mg/dl) and waist/hip ratio (OR = 1.4, 95% CI: 1.2, 1.5; per 0.08) and was inversely associated with high density lipoprotein cholesterol (OR = 0.8, 95% CI: 0.7, 0.9; per 0.4 mmol/liter). Starting to smoke (OR = 1.5, 95% CI: 1.2, 2.0) and becoming obese (OR = 2.4, 95% CI: 1.8, 3.1) during the study were also associated with increased risk. The associations were similar across race and gender groups. These data suggest that, in addition to weight gain, hyperuricemia, dyslipidemia, and smoking can be detected prior to development of hyperinsulinemia.
diabetes, non-insulin-dependent; hyperinsulinemia; insulin resistance; longitudinal studies; metabolic syndrome X; risk factors
Abbreviations: Abbreviations: ARIC, Atherosclerosis Risk in Communities; BMI, body mass index; HDL, high density lipoprotein; LDL, low density lipoprotein.
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