Issue 129 Item 11 ‘Hypertriglyceridemic Waist’ Predicts Presence of Insulin Resi

More than two-thirds of middle-aged men with a waist size of 35 inches (90 cm or more) and triglyceride levels of 180 mg/dL (2.0 mmol/L) or more have metabolic abnormalities of insulin resistance syndrome >Dr. Jean Pierre Despres, director of research, Quebec Heart Institute, Quebec City, and colleagues measured the waist circumference of 335 middle-aged men and determined both triglyceride and fasting insulin levels. Men were then divided according to a waist circumference of less than 90 cm or 90 cm or more, as well as by triglyceride levels of 2.0 mmol/L or more, or under 2.0 mmol/L.

The presence of hyperinsulinemia was defined as a fasting insulin value of 85 pmol/L or more. Hyperinsulinemia was present in only 4% of men with a waist circumference of less than 90 cm and triglyceride levels of less than 2.0 mmol/L, and in 7% of men with isolated hypertriglyceridemia.

High fasting insulin levels were found in significantly more men–38%–who had a waist circumference of 90 cm or more, the researchers found, and in 68% of men with a ‘hypertriglyceridemic waist,’ i.e., a waistline of 90 cm or more and triglyceride levels of 2.0 mmol/L or more.

It’s almost like having an insulin assay because the difference between men with a ‘hypertriglyceridemic waist’ and those without is huge, so our message is very simple: physicians need to get out their tape measure and measure every patient’s waist to screen for the presence of hyperinsulinemia, that according to Dr. Despres.