28 June 2010 - Insulin resistance (IR) is moderately high in the Thai population and is associated with elevated triglycerides, low high-density lipoprotein (HDL) cholesterol, and hypertension, write Vitool Lohsoonthorn, MD (Chulalongkorn University, Bangkok, Thailand) and colleagues in the journal Diabetes Research and Clinical Practice. 

"Many longitudinal studies in adults have demonstrated that IR is a risk factor for the development of type 2 diabetes," they note. "Moreover, IR has also been reported as being strongly associated with the development of incident atherosclerotic disorders." 

The researchers therefore investigated the prevalence of IR, measured using the homeostasis model assessment of IR (HOMA-IR), in a cross section of the adult Thai population comprising 227 men and 990 women who underwent routine health check-ups. The participants had to be 35 years or older at the time of their check-up to be included in the study. 

In total, 25.1% of the men and 21.5% of the women were classified as having insulin resistance (HOMA-IR of 1.56 or more and 1.64 or more, respectively). 

Vitool and collegaues assessed associations between various cardiovascular risk factors and HOMA-IR. They found that HOMA-IR levels were significantly and positively correlated with body mass index, waist circumference, percentage body fat, and triglycerides, and negatively correlated with HDL cholesterol concentration. 

Compared with men with the lowest HOMA-IR levels (below 0.45), those with the highest (1.58 or above) were 2.83, 2.79, and 2.76 times more likely to have high triglycerides, low HDL cholesterol, and hypertension, respectively. 

Similarly, in women with the highest (1.51 or above) versus the lowest (below 0.47) HOMA-IR, the risk for high triglycerides, low HDL cholesterol, and hypertension increased 8.31-, 5.63-, and 2.21-fold, respectively. 

"Insulin resistance could contribute to the development of type 2 diabetes," say the investigators. "Given the considerable individual and public health implications with respect to associated morbidity and mortality rates, it is critical to identify these at-risk individuals so that preventative and therapeutic protocols can be effectively directed to lower their cardiovascular risk and to delay (and/or prevent) the onset of type 2 diabetes mellitus."