Obesity type and clustering of insulin resistance-associated cardiovascular risk factors in middle-aged men and women

To examine different clusterings of the insulin resistance-associated cardiovascular risk factors with respect to different types of obesity. A screening programme for obesity (body mass index; BMI> or =30 kg/m2) and abdominal adiposity (waist-to-hip ratio; WHR > or = 1.00 in men and > or = 0.88 in women). Pieksämäki District Health Centre and the Community Health Centre of the City of Tampere, Finland. All volunteers were either aged 36, 41, 46 or 51 y (n=1148) and living in the town of Pieksämäki, with a control population of 162 subjects in the City of Tampere. Different clusterings of: 1) hypertension (a systolic blood pressure > or = 160 mmHg and/or a diastolic blood pressure > or = 95 mmHg or concurrent drug treatment for hypertension); 2) hypertriglyceridaemia > or = 1.70 mmol/l; 3) a low level of high-density-lipoprotein (HDL) cholesterol; < 1.00 mmol/l in men, < 1.20 mmol/l in women; 4) abnormal glucose metabolism (impaired glucose tolerance or non-insulin-dependent diabetes) and 5) hyperinsulinaemia with a fasting plasma insulin > or = 13.0 mU/l. The prevalence of a cluster consisting of dyslipidaemia (hypertriglyceridaemia and/or low HDL-cholesterol) and insulin resistance (abnormal glucose metabolism and/or hyperinsulinaemia) was found to be 4% in the control subjects, 18% in the abdominal adipose subjects (WHR > or = 1.00 in men and > or = 0.88 in women with a BMI < 30 kg/m2), 28% in the 'pure' obese subjects (BMI> or = 30 kg/m2 with WHR < 1.00 in men and < 0.88 in women), and 46% in the central obese subjects (subjects showing both 'pure' obesity and abdominal adiposity). The prevalence rates of the other clusterings of abnormalities varied similarly according to the type of obesity. Clusterings of insulin resistance-associated abnormalities were related to the type of obesity in both middle-aged men and middle-aged women.