Cardio-metabolic risk factors and insulin resistance

Background. The main cardiovascular risk factors have been investigated over the past few decades. Key factors include dyslipidemia, high blood pressure, smoking, diabetes mellitus and obesity. According to research data, it is important to examine the significance of the homeostasis model of insulin resistance (HOMA-IR) in the Ukrainian population, particularly among individuals with cardio-metabolic risk factors that lead to the development of atherosclerotic, non-atherosclerotic cardiovascular diseases and metabolic complications. Materials and methods. One hundred and ninety-nine individuals were examined: 152 patients with stage I–II arterial hypertension (AH) and 47 individuals without any previously diagnosed diseases. All patients were stratified into six groups according to the number of components of metabolic syndrome (MetS): group 0 — no components of MetS (12 practically healthy individuals); group 1 — the presence of 1 component of MetS; group 2 — the presence of 2 components of MetS; group 3 — three-component MetS; group 4 — four-component MetS; group 5 — five-component MetS. Results. The involvement of a higher number of MetS components was associated with an increase in the IR marker — HOMA-IR. With an increase in the number of MetS components, the body mass index, waist circumference (WC), uric acid and glycemia indicators increased linearly. The incidence of prediabetes, hyperuricemia and AH increased linearly with an increase in the components of MetS. AH and abdominal obesity were early manifestations of metabolic changes. The statistical differences in cardiometabolic risk are more significant when the HOMA-IR exceeded 1.78. When the threshold was exceeded, a significant increase in WC, ttriglycerides, uric acid and C-reactive protein was found in the observed patient groups, and with HOMA-IR values > 3.89, the probability of detecting MetS signs significantly increases. Conclusions. With an increase in the components of MetS, even at the stage of its formation, an increase in the insulin resistance index — HOMA-IR was observed. Abdominal obesity and AH are the most common manifestations at the stage of MetS formation. The average HOMA-IR value of 3.89 aligns with the criteria of MetS, while HOMA-IR above 1.78 is associated with a significance of cardio-metabolic risk factors such as WC, triglycerides, uric acid and C-reactive protein.