Prevalence of Insulin Resistance in the Hungarian General and Roma Populations as Defined by Using Data Generated in a Complex Health (Interview and Examination) Survey
Abstract
:1. Introduction
2. Materials and Methods
2.1. Sample Representative of the Hungarian Roma (HR) Population Living in Segregated Colonies in Northeast Hungary
2.2. Sample Representative of the Hungarian General (HG) Population Living in Northeast Hungary
2.3. Pillars of the Complex (Health Interview and Examination) Survey
2.3.1. I. Questionnaire-Based Interviews
2.3.2. II. Physical Examinations
2.3.3. III. Laboratory Examinations
2.4. Creation of the Database
2.5. Determination of the Prevalence of Metabolic Syndrome and Its Components
2.6. Insulin Sensitivity/Resistance Indices Calculated by Using Fasting Serum/Plasma Concentrations of Insulin, Glucose, HDL-C and Triglycerides
2.6.1. Determination of the Cut-Off Values of Surrogate Measures for Insulin Resistance
2.6.2. Determination of the Prevalence of IR by Using Different Surrogate Indices
2.7. Statistical Analysis
2.8. Ethical Statement
3. Results
3.1. Demographic and Anthropometric Characteristics of the Samples
3.2. The Prevalence of MetS and Its Components in the Study Populations
3.3. Findings Used to Estimate the Risk of IR for MetS
3.4. Determination of Cut-Off Points for IR Surrogate Indices
3.5. Prevalence of IR in the Hungarian General and Hungarian Roma Populations
4. Discussion
5. Conclusions
Author Contributions
Funding
Conflicts of Interest
References
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Hungarian General Population (n = 397) | Hungarian Roma Population (n = 368) | p-Value | ||
---|---|---|---|---|
Prevalence % (n) | Prevalence % (n) | |||
Sex | Male | 44.58 (177) | 26.36 (97) | <0.001 |
Female | 55.42 (220) | 73.64 (271) | ||
Age groups | 20–34 | 24.69 (98) | 28.80 (106) | 0.434 |
35–49 | 39.04 (155) | 37.23 (137) | ||
50–64 | 36.27 (144) | 33.97 (125) | ||
Mean (95% CI) | Mean (95% CI) | p-Value | ||
Age (years) | 44.18 (42.97–45.38) | 42.82 (41.57–44.07) | 0.123 | |
Weight (kg) | 77.80 (76.12–79.47) | 71.91 (69.93–73.89) | <0.001 | |
Height (cm) | 168.73 (167.79–169.68) | 161.15 (160.20–162.11) | <0.001 | |
BMI (kg/m2) | 27.27 (26.74–27.81) | 27.61 (26.90–28.31) | 0.918 |
Metabolic Syndrome and Its Components | Hungarian General Population (n = 397) | Hungarian Roma Population (n = 368) | p-Value | Males in the HG Population (n = 177) | Males in the HR Population (n = 97) | p-Value | Females in the HG Population (n = 220) | Females in the HR Population (n = 271) | p-Value |
---|---|---|---|---|---|---|---|---|---|
Prevalence % (95% CI) | Prevalence % (95% CI) | Prevalence % (95% CI) | Prevalence % (95% CI) | Prevalence % (95% CI) | Prevalence % (95% CI) | ||||
Central obesity | 75.56 (70.11–78.65) | 73.37 (68.68–77.69) | 0.719 | 64.41 (57.17–71.18) | 58.76 (48.83–68.18) | 0.356 | 82.73 (77.32–87.28) | 78.60 (73.43–83.16) | 0.251 |
Raised blood pressure or treated hypertension | 57.18 (52.27–61.98) | 54.08 (48.97–59.12) | 0.378 | 60.45 (53.13–67.44) | 57.73 (47.79–67.22) | 0.661 | 54.55 (47.94–61.03) | 52.77 (46.82–58.66) | 0.694 |
Raised fasting plasma glucose concentration or previously diagnosed diabetes mellitus | 25.19 (21.11–29.63) | 23.91 (19.77–28.46) | 0.666 | 27.12 (20.98–34.00) | 31.96 (23.31–41.66) | 0.398 | 23.64 (18.39–29.57) | 21.03 (16.50–26.18) | 0.490 |
Raised triglyceride level or treated lipid disorder | 37.28 (32.63–42.11) | 37.77 (32.93–42.81) | 0.767 | 42.94 (35.81–50.30) | 51.55 (41.68–61.32) | 0.172 | 32.73 (26.78–39.12) | 32.84 (27.46–38.59) | 0.979 |
Reduced HDL cholesterol level or treated lipid disorder | 36.27 (31.66–41.09) | 55.98 (50.88–60.99) | <0.001 | 32.20 (25.65–39.33) | 47.42 (37.68–57.31) | 0.013 | 39.55 (33.26–46.11) | 59.04 (53.12–64.77) | <0.001 |
Metabolic syndrome | 39.80 (35.07–44.67) | 44.02 (39.01–49.12) | 0.232 | 37.85 (30.95–45.15) | 46.39 (36.70–56.30) | 0.169 | 41.36 (35.00–47.95) | 43.17 (37.37–49.12) | 0.687 |
Without Mets | With Mets | ||||||||
---|---|---|---|---|---|---|---|---|---|
HG (n = 397) | HR (n = 368) | p-Value | HG (n = 239) | HR (n = 206) | p-Value | HG (n = 158) | HR (n = 162) | p-Value | |
Mean | Mean | Mean | |||||||
Fasting insulin (mU/L) | 15.82 | 16.67 | 0.892 | 11.02 | 11.27 | 0.371 | 23.10 | 23.54 | 0.736 |
Fasting glucose (mmol/L) | 5.25 | 5.10 | 0.105 | 4.77 | 4.63 | 0.158 | 5.98 | 5.70 | 0.177 |
Fasting TG (mmol/L) | 1.58 | 1.61 | 0.375 | 1.18 | 1.12 | 0.941 | 2.19 | 2.23 | 0.386 |
HDL-C (mmol/L) | 1.37 | 1.26 | <0.001 | 1.49 | 1.37 | 0.001 | 1.19 | 1.12 | 0.006 |
Waist circumference (cm) | 96.03 | 94.78 | 0.286 | 89.6 | 86.9 | 0.008 | 105.8 | 104.8 | 0.580 |
Systolic blood pressure (mmHg) | 126.75 | 123.71 | < 0.001 | 122.4 | 119.3 | 0.007 | 133.4 | 129.3 | 0.001 |
Diastolic blood pressure (mmHg) | 78.82 | 79.63 | 0.600 | 76.9 | 76.6 | 0.469 | 81.7 | 83.4 | 0.229 |
Prevalence of antihypertensive treatment (%) | 28.46 | 31.52 | 0.356 | 12.97 | 13.11 | 0.966 | 51.90 | 54.94 | 0.586 |
Prevalence of antidiabetic treatment (%) | 6.05 | 11.14 | 0.012 | 0.84 | 1.94 | 0.314 | 13.92 | 22.84 | 0.040 |
Prevalence of lipid lowering therapy (%) | 6.80 | 11.68 | 0.019 | 1.67 | 1.46 | 0.845 | 14.56 | 24.69 | 0.023 |
Indices | Without MetS | With MetS | |||||||
---|---|---|---|---|---|---|---|---|---|
HG (n = 397) | HR (n = 368) | p-Value | HG (n = 239) | HR (n = 206) | p-Value | HG (n = 158) | HR (n = 162) | p-Value | |
Mean | Mean | Mean | |||||||
HOMA-IR | 4.07 | 4.32 | 0.722 | 2.51 | 2.47 | 0.321 | 6.44 | 6.68 | 0.568 |
QUICKI | 0.34 | 0.35 | 0.722 | 0.36 | 0.37 | 0.320 | 0.32 | 0.32 | 0.568 |
McAuley index | 6.96 | 7.00 | 0.746 | 7.94 | 8.20 | 0.375 | 5.48 | 5.47 | 0.881 |
TG/HDL-C ratio | 1.36 | 1.49 | 0.033 | 0.90 | 0.90 | 0.110 | 2.05 | 2.24 | 0.085 |
TyG index | 4.64 | 4.64 | 0.871 | 4.47 | 4.45 | 0.743 | 4.88 | 4.88 | 0.978 |
A | ||||||||||||
Variables | Hungarian General Population (n = 397) | Hungarian Roma Population (n = 368) | Combined Population (n = 765) | |||||||||
Cop | Sens./Spec. | YI | AUC | Cop | Sens./Spec. | YI | AUC | Cop | Sens./Spec. | YI | AUC | |
Fasting insulin (mU/L) | 12.480 | 0.614/0.749 | 0.363 | 0.735 | 10.100 | 0.728/0.650 | 0.379 | 0.726 | 11.855 | 0.634/0.712 | 0.347 | 0.730 |
Fasting glucose (mmol/L) | 5.350 | 0.506/0.828 | 0.335 | 0.696 | 5.550 | 0.364/0.927 | 0.291 | 0.674 | 5.350 | 0.450/0.852 | 0.302 | 0.684 |
Fasting TG (mmol/L) | 1.590 | 0.709/0.828 | 0.537 | 0.826 | 1.750 | 0.673/0.932 | 0.605 | 0.857 | 1.590 | 0.713/0.849 | 0.562 | 0.841 |
HDL-C (mmol/L) | 1.195 | 0.620/0.808 | 0.428 | 0.745 | 1.210 | 0.753/0.675 | 0.428 | 0.744 | 1.195 | 0.675/0.753 | 0.428 | 0.743 |
B | ||||||||||||
Indices | Hungarian General Population (n = 397) | Hungarian Roma Population (n = 368) | Combined Population (n = 765) | |||||||||
Cop | Sens./Spec. | YI | AUC | Cop | Sens./Spec. | YI | AUC | Cop | Sens./Spec. | YI | AUC | |
HOMA-IR | 2.291 | 0.747/0.695 | 0.441 | 0.763 | 2.224 | 0.710/0.660 | 0.370 | 0.744 | 2.320 | 0.709/0.690 | 0.399 | 0.753 |
QUICKI | 0.337 | 0.747/0.695 | 0.441 | 0.763 | 0.338 | 0.710/0.660 | 0.370 | 0.744 | 0.336 | 0.709/0.690 | 0.399 | 0.753 |
McAuley index | 6.297 | 0.741/0.782 | 0.523 | 0.825 | 6.768 | 0.833/0.704 | 0.537 | 0.828 | 5.989 | 0.697/0.827 | 0.524 | 0.827 |
TG/HDL-C ratio | 1.304 | 0.722/0.833 | 0.554 | 0.831 | 1.274 | 0.747/0.864 | 0.611 | 0.855 | 1.274 | 0.734/0.843 | 0.574 | 0.843 |
TyG index | 4.694 | 0.791/0.820 | 0.611 | 0.858 | 4.685 | 0.759/0.869 | 0.628 | 0.867 | 4.694 | 0.772/0.843 | 0.615 | 0.862 |
Indices | Prevalence of Insulin Resistance (%) Based on the Cut-Off Points Identified in the Study Populations (95% CI) | p-Value | Prevalence of Insulin Resistance (%) Based on the Cut-Off Points Identified in the Combined Population (95% CI) | p-Value | ||
---|---|---|---|---|---|---|
Hungarian General Population (n = 397) | Hungarian Roma Population (n = 368) | Hungarian General Population (n = 397) | Hungarian Roma Population (n = 368) | |||
HOMA-IR | 48.11 (43.22–53.02) n = 191 | 49.73 (44.64–54.82) n = 185 | 0.550 | 47.61 (42.73–52.52) n = 189 | 47.83 (42.76–52.93) n = 176 | 0.952 |
QUICKI | 48.11 (43.22–53.02) n = 191 | 49.46 (44.37–54.55) n = 182 | 0.710 | 47.10 (42.23–52.02) n = 187 | 47.83 (42.76–52.93) n = 176 | 0.841 |
McAuley index | 42.57 (37.77–47.47) n = 169 | 53.26 (48.15–58.32) n = 196 | 0.003 | 37.78 (33.12–42.63) n = 150 | 40.76 (35.83–45.84) n = 150 | 0.399 |
TG/HDL-C ratio | 38.79 (34.09–43.65) n = 154 | 40.49 (35.56–45.56) n = 149 | 0.631 | 39.29 (34.58–44.16) n = 156 | 40.49 (35.56–45.56) n = 149 | 0.736 |
TyG index | 42.32 (37.53–47.22) n = 168 | 40.76 (35.83–45.84) n = 150 | 0.663 | 42.32 (37.53–47.22) n = 168 | 40.49 (35.56–45.56) n = 149 | 0.608 |
A | |||||||||
HOMA-IR | McAuley Index | TyG Index | |||||||
Age Groups | HG | HR | p-Value | HG | HR | p-Value | HG | HR | p-Value |
Prevalence %; n | Prevalence %; n | Prevalence %; n | |||||||
20–34 | 44.90; n = 90 | 50.00; n = 53 | 0.466 | 32.65; n = 32 | 40.57; n = 43 | 0.242 | 32.65; n = 32 | 30.19; n = 32 | 0.705 |
35–49 | 37.42; n = 58 | 48.18; n = 66 | 0.064 | 33.55; n = 52 | 41.61; n = 57 | 0.155 | 38.06; n = 59 | 40.88; n = 56 | 0.624 |
50–64 | 60.42; n = 87 | 45.60; n = 57 | 0.015 | 45.83; n = 66 | 40.00; n = 50 | 0.335 | 53.47; n = 77 | 48.80; n = 61 | 0.444 |
p for trend | 0.004 | 0.502 | 0.044 | 0.965 | 0.002 | 0.016 | |||
B | |||||||||
HOMA-IR | McAuley Index | TyG Index | |||||||
Sex | HG | HR | p for Ethnicity | HG | HR | p for Ethnicity | HG | HR | p for Ethnicity |
Prevalence %; n | Prevalence %; n | Prevalence %; n | |||||||
Males | 49.72; n = 88 | 50.52; n = 49 | 0.899 | 44.07; n = 78 | 49.48; n = 48 | 0.021 | 49.15; n = 87 | 51.55; n = 50 | 0.705 |
Females | 45.91; n = 101 | 46.86; n = 127 | 0.833 | 32.70; n = 72 | 37.64; n = 102 | 0.042 | 36.82; n = 81 | 36.53; n = 99 | 0.948 |
p for sex | 0.450 | 0.537 | 0.390 | 0.258 | 0.013 | 0.010 |
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Ádány, R.; Pikó, P.; Fiatal, S.; Kósa, Z.; Sándor, J.; Bíró, É.; Kósa, K.; Paragh, G.; Bácsné Bába, É.; Veres-Balajti, I.; et al. Prevalence of Insulin Resistance in the Hungarian General and Roma Populations as Defined by Using Data Generated in a Complex Health (Interview and Examination) Survey. Int. J. Environ. Res. Public Health 2020, 17, 4833. https://doi.org/10.3390/ijerph17134833
Ádány R, Pikó P, Fiatal S, Kósa Z, Sándor J, Bíró É, Kósa K, Paragh G, Bácsné Bába É, Veres-Balajti I, et al. Prevalence of Insulin Resistance in the Hungarian General and Roma Populations as Defined by Using Data Generated in a Complex Health (Interview and Examination) Survey. International Journal of Environmental Research and Public Health. 2020; 17(13):4833. https://doi.org/10.3390/ijerph17134833
Chicago/Turabian StyleÁdány, Róza, Péter Pikó, Szilvia Fiatal, Zsigmond Kósa, János Sándor, Éva Bíró, Karolina Kósa, György Paragh, Éva Bácsné Bába, Ilona Veres-Balajti, and et al. 2020. "Prevalence of Insulin Resistance in the Hungarian General and Roma Populations as Defined by Using Data Generated in a Complex Health (Interview and Examination) Survey" International Journal of Environmental Research and Public Health 17, no. 13: 4833. https://doi.org/10.3390/ijerph17134833