Resumo

BONNEAU, G.A et al. Insulin resistance and its relation to anthropometric measurements and blood pressure in a group of apparently healthy hospital employees. Rev. argent. endocrinol. metab. [online]. 2011, vol.48, n.1, pp.8-15. ISSN 1851-3034.

According to 2008 data from the Ministry of Public Health of the Province of Misiones, cardiovascular disease is the main cause of mortality in that province, with a proportional mortality ratio of 28.3 %, and with a process known as arteriosclerosis as the main responsible factor. Arteriosclerosis is a chronic inflammatory process where endothelial dysfunction plays a major role. Insulin resistance (IR), described as a condition in which there is a decrease in the biological function of insulin and high plasma levels of insulin are required to maintain metabolic homeostasis, promotes atherosclerotic development and its presence is associated with an increased risk of cardiovascular disease. Our aim was to determine the frequency of hyperinsulinemia and IR in a group of employees at the Public Provincial Hospital Dr. Ramón Madariaga, to correlate IR with age, blood pressure, general and abdominal obesity and to evalúate our subjects' performance using the HOMA Índex. One-hundred and seventy subjects of both genders (134 females and 36 males) with an age range between 27 and 74 years oíd were studied. Participation in the trial was voluntary and written consent was obtained using an authorization model based on the Declaration of Helsinki. Weight, height and waist circumference data were recorded under WHO standards. Subjects were classified as normal, overweight and obese depending on their Body Mass índex. Blood pressure was measured with a mercury sphygmomanometer and following the American Heart Association recommendations. Blood samples were collected after 8 hours of fasting and glucose was measured by enzymatic colorimetric methods (CV = 2.38 %). Insulin was measured by radioimmunoanalysis (CV=8 %). The Internal Quality Control was performed with a serum pool prepared in the laboratory, and the External Quality Control was carried out with controls provided by the Argentine Biochemical Foundation. All the statistical analyses were performed using the Epiinfo 2000 program, with a confidence interval of 95 % and a significance level <0.05. The frequencies of IR and hyperinsulinemia obtained were 7.1 % and 8.2 %, respectively The HOMA Índex showed a highly significant correlation (p<0.001) for waist circumference (abdominal obesity), body mass Índex (obesity) and blood pressure. When assessing the HOMA Índex performance, it was found that individuáis with abdominal obesity had a higher IR (p<0.001). In addition, the IR Índex mean valué increased with body mass Índex (p<0.001). Subjects with prehypertension and hypertension showed higher HOMA valúes as compared to subjects with normal blood pressure (p<0.001), when the evaluation was performed according to the different blood pressure categories. The assessment of insulin resistance showed a clear relationship between obesity, abdominal obesity and hypertension. This assessment will make it possible to identify individuáis at increased risk for cardiovascular disease so as to implement treatment measures (diet, physical activity and / or pharmacological treatment) to delay or prevent the occurrence of disease, offering our patients an improved quality of life. No competing financial interests exist.

Palavras-chave : Cardiovascular disease; Insulin resistance; Cardiovascular Risk factors.

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