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Glycated Hemoglobin, Fasting Insulin and the Metabolic Syndrome in Males. Cross-Sectional Analyses of the Aragon Workers' Health Study Baseline.

Saravia G, Civeira F, Hurtado-Roca Y, Andres E, Leon M, Pocovi M, Ordovas J, Guallar E, Fernandez-Ortiz A, Casasnovas JA, Laclaustra M - PLoS ONE (2015)

Bottom Line: We used baseline data from 3200 non-diabetic male participants in the Aragon Workers' Health Study.All ORs were statistically significant.Among non-metabolic syndrome patients, a small insulin elevation identified risk factor clustering.

View Article: PubMed Central - PubMed

Affiliation: Department of Epidemiogy, Atherothrombosis and Imaging, Spanish National Center for Cardiovascular Research (CNIC), Madrid, Spain.

ABSTRACT

Background and aims: Glycated hemoglobin (HbA1c) is currently used to diagnose diabetes mellitus, while insulin has been relegated to research. Both, however, may help understanding the metabolic syndrome and profiling patients. We examined the association of HbA1c and fasting insulin with clustering of metabolic syndrome criteria and insulin resistance as two essential characteristics of the metabolic syndrome.

Methods: We used baseline data from 3200 non-diabetic male participants in the Aragon Workers' Health Study. We conducted analysis to estimate age-adjusted odds ratios (ORs) across tertiles of HbA1c and insulin. Fasting glucose and Homeostatic model assessment - Insulin Resistance were used as reference. Here we report the uppermost-to-lowest tertile ORs (95%CI).

Results: Mean age (SD) was 48.5 (8.8) years and 23% of participants had metabolic syndrome. The ORs for metabolic syndrome criteria tended to be higher across HbA1c than across glucose, except for high blood pressure. Insulin was associated with the criteria more strongly than HbA1c and similarly to Homeostatic model assessment - Insulin Resistance (HOMA-IR). For metabolic syndrome, the OR of HbA1c was 2.68, of insulin, 11.36, of glucose, 7.03, and of HOMA-IR, 14.40. For the clustering of 2 or more non-glycemic criteria, the OR of HbA1c was 2.10, of insulin, 8.94, of glucose, 1.73, and of HOMA-IR, 7.83. All ORs were statistically significant. The areas under the receiver operating characteristics curves for metabolic syndrome were 0.670 (across HbA1c values) and 0.770 (across insulin values), and, for insulin resistance, 0.647 (HbA1c) and 0.995 (insulin). Among non-metabolic syndrome patients, a small insulin elevation identified risk factor clustering.

Conclusions: HbA1c and specially insulin levels were associated with metabolic syndrome criteria, their clustering, and insulin resistance. Insulin could provide early information in subjects prone to develop metabolic syndrome.

No MeSH data available.


Related in: MedlinePlus

ROC curves of HbA1c, insulin, glycemia and HOMA-IR for metabolic syndrome criteria.ROC curves for detecting individually each metabolic syndrome criteria. The small circles indicate the sensitivity and specificity when using the tertiles of each variable as cut-offs. For high glucose, the glycemia curve can not be seen as it lies exactly at the left and upper borders.
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pone.0132244.g001: ROC curves of HbA1c, insulin, glycemia and HOMA-IR for metabolic syndrome criteria.ROC curves for detecting individually each metabolic syndrome criteria. The small circles indicate the sensitivity and specificity when using the tertiles of each variable as cut-offs. For high glucose, the glycemia curve can not be seen as it lies exactly at the left and upper borders.

Mentions: The odds of having metabolic syndrome increased by a factor of 7.16 (95%CI: 5.14, 10.01) per unit of HbA1c. Glycated hemoglobin (HbA1c) also was associated with HOMA-IR: per each HbA1c unit increase, HOMA-IR was multiplied by 1.72 (95%CI: 1.60, 1.85). Compared to participants in the lower tertile of HbA1c, those in the upper tertile had a higher prevalence of all diagnostic criteria for the metabolic syndrome, their clustering in the metabolic syndrome, the clustering of factors other than high glucose (2-or-more-non-glycemic-criteria and 3-or-more-non-glycemic-criteria), and insulin resistance (Table 2). Odds ratios for diagnostic criteria for the metabolic syndrome for HbA1c tended to be higher than those for fasting glucose, except for high blood pressure. The odds ratios for HbA1c were also higher than those of fasting glucose for non-glycemic-criteria clusters. HbA1c tended to perform better than glucose in discriminating these conditions, as seen in ROC curves (Figs 1 and 2).


Glycated Hemoglobin, Fasting Insulin and the Metabolic Syndrome in Males. Cross-Sectional Analyses of the Aragon Workers' Health Study Baseline.

Saravia G, Civeira F, Hurtado-Roca Y, Andres E, Leon M, Pocovi M, Ordovas J, Guallar E, Fernandez-Ortiz A, Casasnovas JA, Laclaustra M - PLoS ONE (2015)

ROC curves of HbA1c, insulin, glycemia and HOMA-IR for metabolic syndrome criteria.ROC curves for detecting individually each metabolic syndrome criteria. The small circles indicate the sensitivity and specificity when using the tertiles of each variable as cut-offs. For high glucose, the glycemia curve can not be seen as it lies exactly at the left and upper borders.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4524641&req=5

pone.0132244.g001: ROC curves of HbA1c, insulin, glycemia and HOMA-IR for metabolic syndrome criteria.ROC curves for detecting individually each metabolic syndrome criteria. The small circles indicate the sensitivity and specificity when using the tertiles of each variable as cut-offs. For high glucose, the glycemia curve can not be seen as it lies exactly at the left and upper borders.
Mentions: The odds of having metabolic syndrome increased by a factor of 7.16 (95%CI: 5.14, 10.01) per unit of HbA1c. Glycated hemoglobin (HbA1c) also was associated with HOMA-IR: per each HbA1c unit increase, HOMA-IR was multiplied by 1.72 (95%CI: 1.60, 1.85). Compared to participants in the lower tertile of HbA1c, those in the upper tertile had a higher prevalence of all diagnostic criteria for the metabolic syndrome, their clustering in the metabolic syndrome, the clustering of factors other than high glucose (2-or-more-non-glycemic-criteria and 3-or-more-non-glycemic-criteria), and insulin resistance (Table 2). Odds ratios for diagnostic criteria for the metabolic syndrome for HbA1c tended to be higher than those for fasting glucose, except for high blood pressure. The odds ratios for HbA1c were also higher than those of fasting glucose for non-glycemic-criteria clusters. HbA1c tended to perform better than glucose in discriminating these conditions, as seen in ROC curves (Figs 1 and 2).

Bottom Line: We used baseline data from 3200 non-diabetic male participants in the Aragon Workers' Health Study.All ORs were statistically significant.Among non-metabolic syndrome patients, a small insulin elevation identified risk factor clustering.

View Article: PubMed Central - PubMed

Affiliation: Department of Epidemiogy, Atherothrombosis and Imaging, Spanish National Center for Cardiovascular Research (CNIC), Madrid, Spain.

ABSTRACT

Background and aims: Glycated hemoglobin (HbA1c) is currently used to diagnose diabetes mellitus, while insulin has been relegated to research. Both, however, may help understanding the metabolic syndrome and profiling patients. We examined the association of HbA1c and fasting insulin with clustering of metabolic syndrome criteria and insulin resistance as two essential characteristics of the metabolic syndrome.

Methods: We used baseline data from 3200 non-diabetic male participants in the Aragon Workers' Health Study. We conducted analysis to estimate age-adjusted odds ratios (ORs) across tertiles of HbA1c and insulin. Fasting glucose and Homeostatic model assessment - Insulin Resistance were used as reference. Here we report the uppermost-to-lowest tertile ORs (95%CI).

Results: Mean age (SD) was 48.5 (8.8) years and 23% of participants had metabolic syndrome. The ORs for metabolic syndrome criteria tended to be higher across HbA1c than across glucose, except for high blood pressure. Insulin was associated with the criteria more strongly than HbA1c and similarly to Homeostatic model assessment - Insulin Resistance (HOMA-IR). For metabolic syndrome, the OR of HbA1c was 2.68, of insulin, 11.36, of glucose, 7.03, and of HOMA-IR, 14.40. For the clustering of 2 or more non-glycemic criteria, the OR of HbA1c was 2.10, of insulin, 8.94, of glucose, 1.73, and of HOMA-IR, 7.83. All ORs were statistically significant. The areas under the receiver operating characteristics curves for metabolic syndrome were 0.670 (across HbA1c values) and 0.770 (across insulin values), and, for insulin resistance, 0.647 (HbA1c) and 0.995 (insulin). Among non-metabolic syndrome patients, a small insulin elevation identified risk factor clustering.

Conclusions: HbA1c and specially insulin levels were associated with metabolic syndrome criteria, their clustering, and insulin resistance. Insulin could provide early information in subjects prone to develop metabolic syndrome.

No MeSH data available.


Related in: MedlinePlus