Abstract
OBJECTIVES: To evaluate the cardiovascular risk factors (CVRF), their relationship with insulin resistance (IR) and pancreatic beta-cell (PBC) function in a known non-diabetic population, and to follow its progress over a period of 5 years. DESIGN: Nested case-control study developed in two phases: the identification and characterisation of the cohort to study and the follow up. SETTING: Urban Primary Care Centre. PARTICIPANTS: A non-diabetic population sample from 40 to 70 years. MAIN MEASUREMENTS: History of CVRF, physical examination (body mass index, abdominal girth, blood pressure), laboratory tests (fasting glucose, lipid profile and fasting insulin) and calculation of IR and PBC using the Homeostasis Model Assessment mathematical program. RESULTS: Identification phase: 326 subjects. CVRF 32.5% dyslipaemia, 28.8% smoking, 28.2% obesity and 24.8% increased blood pressure. Number of CVRF: 37.7% had one, 21.5% two, 10.1% three and 2.1% four. Relationship between number of CVRF and IR. More IR in hypertensive, obese and dyslipaemic subjects. Follow up phase (5 years): 121 subjects. Significant proportion of dyslipaemia and impaired fasting glucose (IFG). CONCLUSIONS: The most common CVRF were dyslipaemia, smoking, obesity and raised blood pressure, with more IR in patients with high blood pressure, dyslipaemia and obesity and a higher number of CVRF in comparison with the rest of the population. At five years of follow up, an increase was only observed in the number of dyslipaemia and IFG and no reduction was achieved in the percentage of active smokers.