Metabolic Syndrome and Insulin Resistance in Obese Patients

Abstract

Background: Metabolic syndrome (MS), diabetes mellitus (DM), and cardiovascular disease (CVD) have been linked to insulin resistance (IR) and its metabolic abnormalities in both young and old people. Today, more young people are diagnosed with MS.Objectives: to evaluate the hemostasis model of assessment (HOMA) of IR in diagnosing MS in obese patients.Patients and methods: A case-control study was conducted at the Clinical Pathology and Internal Medicine Departments and Clinic at Qena University Hospital, Egypt, from 1/1/2022 to 1/7/2022. The study involved 110 subjects divided into 2 groups: 90 MS obese cases with a body mass index (BMI) of > 30 kg/m2, and 20 age- and sex-matched healthy controls. All were clinically evaluated and investigated for serum fasting glucose, fasting insulin, and lipid profile [total cholesterol, LDL, HDL, and triglycerides]. HOMA IR was estimated.Results: hypertension and diabetes have been associated with MS (P =002). MS patients were significantly older with higher weight, waist circumference (WC), midarm circumference (MAC), BMI (p<0.0001), triglyceride, VLDL (P<0.005), uric acid (P=0.009), fasting glucose (P=0.0002), insulin (P=0.007), HOMA-IR (P=0.0201), and a significant decrease in HDL levels (p<0.0001). HOMA-IR was positively correlated with BMI (r=0.266; 0.007), triglycerides (r=0.216 P=0.031), and VLDL (r=0.216; P=0.031), but negatively correlated with HDL (r=-0.205; P=0.040). Central obesity (WC >100cm) is the main independent predictor of MS.Conclusion: HOMA-IR is significantly associated with the MS risk factors in obese adults. BMI is the most effective anthropometric indicator of IR, and central obesity significantly increases the risk of MS.