Document Detail


Syndrome W: a new model of hyperinsulinemia, hypertension and midlife weight gain in healthy women with normal glucose tolerance.
MedLine Citation:
PMID:  11975838     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
To characterize a new insulin resistance syndrome in euglycemic midlife women and the relationship of its features (including hypertension and dyslipidemia), with hyperinsulinemia (AUC insulin > or = 100 microU/mL), retrospective cohort analysis was conducted in 278 consecutive women who presented to a Menopausal Health Program. Of 67 women with midlife weight gain "greater than 20 pounds since their twenties" and body mass indices (BMIs) between 25 and 32 kg/m(2), none of the subjects met criteria for Type 2 diabetes, 5 women had impaired glucose tolerance, and 36 women were hyperinsulinemic. Hyperinsulinemia was a highly statistically significant determinant of hypertension, dyslipidemia, and truncal obesity (Odds Ratios 10.6, 4.0, and 13.7; P values < or = 0.0001, < or = 0.007, and < or = 0.0001) in cross-tabulations. AUC insulin was the best predictor variable of hypertension and dyslipidemia in univariate and multivariate logistic regression models (univariate P values 0.0004 and 0.0088). After adjustment for BMI, age, and estrogen use, the final models, correctly classified, respectively, 74% and 69% of all cases in the dataset (model P values: < or = 0.0001 and < or = 0.0067) and AUC insulin had a log-linear (i.e., dose-dependent) relationship with hypertension and dyslipidemia, which suggests causality. We propose that the constellation of symptoms that includes midlife weight gain, "waist-gain," hypertension, dyslipidemia, and appetite dysregulation in euglycemic women with hyperinsulinemia be titled Syndrome W and suggest that the highly statistically significant relationship of hyperinsulinemia with the characteristic features are evidence of a causal role for insulin in its etiology. The identification of Syndrome W before the onset of overt impaired glucose tolerance, diabetes, or manifestations of coronary artery disease could have important clinical and public health implications for midlife women.
Authors:
Harriette R Mogul; Bernard I Weinstein; Douglas B Mogul; Stephen J Peterson; Shaochun Zhang; Michael Frey; Steven R Gambert; A Louis Southren
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Publication Detail:
Type:  Comparative Study; Evaluation Studies; Journal Article    
Journal Detail:
Title:  Heart disease (Hagerstown, Md.)     Volume:  4     ISSN:  1521-737X     ISO Abbreviation:  Heart Dis     Publication Date:    2002 Mar-Apr
Date Detail:
Created Date:  2002-04-26     Completed Date:  2002-06-07     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  100887299     Medline TA:  Heart Dis     Country:  United States    
Other Details:
Languages:  eng     Pagination:  78-85     Citation Subset:  IM    
Affiliation:
Division of Endocrinology, Department of Medicine, New York Medical College, Valhalla, New York 10595, USA. hrmogul@nymc.edu
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Analysis of Variance
Area Under Curve
Blood Glucose / metabolism
Blood Pressure / physiology
Body Mass Index
Cholesterol, HDL / blood
Cholesterol, LDL / blood
Cohort Studies
Diabetes Mellitus, Type 2 / blood,  complications
Female
Glucose Tolerance Test
Humans
Hyperinsulinism / blood,  complications
Hypertension / blood,  complications
Linear Models
Logistic Models
Metabolic Syndrome X / physiology*
Middle Aged
New York / epidemiology
Predictive Value of Tests
Reference Values
Retrospective Studies
Triglycerides / blood
Weight Gain / physiology
Women's Health
Chemical
Reg. No./Substance:
0/Blood Glucose; 0/Cholesterol, HDL; 0/Cholesterol, LDL; 0/Triglycerides

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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