Interplay Between Insulin Resistance and Body Fat Mass in Evolution of Perturbations Linked to the Metabolic Syndrome in Non-Diabetics: Emphasis on Inflammatory Factors.

Abstract

Objective: Many medical disorders comprising the metabolic syndrome (MS) are becoming increasingly prominent worldwide. Accordingly, much more knowledge is necessary to design the best preventive and therapeutic regimens to combat them effectively. This investigation examines the manner and magnitude of any interplay between body fat mass (FM) and insulin resistance (IR) in the evolution of these disorders using fasting blood glucose (FBG) as the latter's surrogate. Two components of MS, IR and body FM, appear to be particularly important because they have been postulated to be primary driving forces behind the other coexisting entities. Whether and how these two components interact is uncertain to some extent.

Method: Baseline data obtained from healthy, non-diabetic volunteers involved in a number of prior clinical studies were analyzed by examining links between FBG and FM through their individual as well as combined effects on various components of MS.

Results: The present study consists of three phases. Phase 1 establishes that FM, similar to FBG, acting as an independent variable correlates significantly with various components of MS. The results even imply that FM offers a better measure for estimating generalized inflammation. Further, implied from findings in phase 2 is that FM influences inflammation not only by further augmenting IR but by additional means as well. In phase 3, where quartiles were developed based upon FBG and FM levels, the combination of relatively low FM/low FBG possesses significantly less proclivity for intensifying metabolic risk factors compared to the high FM/high FBG subset.

Conclusions: Body FM through augmenting IR as well as another mechanism(s) markedly influences optimal fitness in seemingly normal healthy, non-diabetic volunteers. Maintaining the lowest reasonable levels of IR or body FM should bring one closer to long-term, ideal health, but improving the two jointly is an even better option.