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The Ame rican Journa l o f C lin ica l N utritio n 28 : D
ECEMBER 1975 , pp . 1 38 7 1394 . P rin te d in U .S .A . 1387
In te rre la tion sh ip s o f in su lin , g lu cose , lip id
andan th ropom e tric d a ta in a na tu ra l popu la tio n 2Thom as
C . G ib son ,3 E dw a rd S . H o rton4 and E lbe r i B . W ho r io
n5
ABSTRACT A popu la tio n sam p le o f 1 42 m en and 148 wom en
ag ed 409 w as draw n inCh itte nd en Coun ty . V e rm on t, a nd s
tud ie d fo r in te rre la tio nsh ip s am ong se ve ra l pa ram
ete rs o fo be s ity , fas ting se rum cho les te ro l, tr ig ly ce
rid es , g lu cose a nd insu lin co ncen tra t ion s , an d 2 -ho u
rp ost-Glucola glucose and insu lin co ncen tra tion s . N o s ig n
if ica n t se x d if fe rences w ere ob se rve d w ithre ga rd to m
ean fa s tin g co nce n tra t ion s o f g lucose , ins u lin , ch o
le s te ro l, o r tr ig lyce rid e . P os t-G lu co lainsul in con
centrations were higher in women, part icularly in the older age
groups. Positiveco rre la tio ns w ere ob se rve d b e tw een m ean
lo g fa s ting in su lin co ncen tra tion an d a ll pa ram e te rs
o fo be s ity excep t lo g tr ice ps sk in fo ld th ick nes s in m
en . In a dd itio n , a po s it ive co rre la tio n w as presen tb
e tw een m ean log fas ting insu lin a nd fa s tin g trig ly ce r
ide s . Th e re w as a pos itiv e co rre la tio n b e tw eenfa s
ting trig ly ce r ide s a nd ponde ra l ind ex a nd e st im a ted
pe rce n t bo dy fa t. F as ting trig lyc e rid esc orrelated with
percent id ealw e ig h t in w om en bu t no t in m en and w ith lo
g su bscap u la r sk in fo ldth ic kn ess in m en bu t no t in w om
en . T here w as n o co rre la tio n w ith e ithe r log tric eps s
k in fo ldth ic kn ess o r w ith com b in ed tricep s an d sub scap
u la r s k in fo ld th ickn es s in e ith e r m en o r w om en . N
opos itive co rre la tion s w ere ob se rve d w ith reg a rd to se
rum cho le s te ro l. T he m easurem en t o f g luco sea nd insu
lin con ce n tra tio ns 2 ho urs pos t-G lu co la o r th e ca lc u
la tio n o f ins u lin to g lu cose ra tio s d idnot provide
additional correlations to those ob served from th e fast ing data
alone and i n somein s ta nces co rre la t ion s wh ich e x is ted
in the fa s tin g s ta te w ere la rg e ly o bscu red fo l low ing
ca rb oh y-d ra te a dm in is tra tio n. Am . J . C lin . . su tr.
28 : 13 87 1394 , 1 97 5 .
A ttem p ts have been m ade by m any inves -tiga to rs to es tab
lish w he the r co rre la tionsex is t be tw een va rious m easu
rem en ts o f ove r-w e igh t o r obes ity and se rum concen tra
tionso f g lu cose , in su lin and lip id s (1 18 ). M any o fthese
s tud ie s have been in h igh ly se le c tedpopu la tions , predom
inan tly m a le , and suchcons tra in ts cou ld induce a p rob lem
o f b ia s .W e the re fo re w ish to repo rt da ta ob ta inedfrom
a random ized sam p le o f a na tu ra lpopu la tion ; th is w o rk
shou ld fu rthe r iden tifyand re in fo rce som e im po rtan t s
ign ifican t re -la tionsh ip s in the a rea s ta ted .M ateria ls
and m ethod s
A popu la tion s am p le o f m en and w om en in th e 40 6 9age
gro up wa s draw n in a Ve rm on t c oun tyT he de ve lop -m en t o
f the sam p le fram e and the sam p le d raw fo llow edth e p ro ce
dures d esc rib ed b y M on roe an d F in kn e r an dwe re b ased
on de ta iled m aps w ith ho useh o ld se lec t ion(1 9 ). A m ed
ica l q ue s tion na ire wa s adm in is te red byin te rv iew ers w
ith a respo nse ra te o f 93% . A ll pe rso nswe re a lso o ffe red
m ed ica l eva lu a t ion s . The respo nse ra tefo r th e m ed ic
a l eva lu a tion s w as 70 a to ta l o f 29 4ind iv id ua ls o f w
hom 290 had su ff ic ie n t ly - c om p le te da tafo r inc lus ion
in the p re se n t s tu dy . D a ta ob ta ined from th eq ue stio
nn a ire , phy s ic ian a nd ho sp ita l re co rds fo r a
n um be r o f m ed ica l an d soc io lo g ic pa ram ete rs
showed nos ta t is tica l ly - s ig n ifica n t b ias b e tw een
the re sp on den ts an dn on respo nden ts fo r m ed ica l eva lu a
tio n w ithhe excep-tion o f the fo llow in g n onrespo nden ts ch
a ra c te ris tics .The ir so c ia l an d ed uca tio na l le ve l w
as low er , th ey we reh ea v ie r sm okers , th ey- w o rried less
a bo u t th e ir he a lth an dfew er o f them had had a ro u tin e
ph ys ica l exam in a tio nw ith in the yea r p rio r to in te rv
ie
Th e m ed ica l eva lu a tio ns we re p r im arily c a rd io vas
cu -la r an d com p ris ed a m ed ic a l h is to ry . p hy s ic a l
exam ina -t ion , ch es t X -ra y . ca rd ia c flu o ro scopy . KU
B . 12 -le adEKG , u r ina lys is an d h em atocr it. S tan da rds
fo r th eco llec tion o f an th ro pom e tric da ta we re b ased on
th ere com m enda tion s o f th e Comm itte e o n Nu tri tion a l
An -th ro pom e try (20 ). H e ig h t an d w e igh t w ere m ea su
reds trip pe d , tric ep s a nd su bs ca pu la r sk in fo lds w ere
m ea-su re d to the n ea res t m illim e te r u s in g a La nge sk
in fo ldca lipe r. T he m ean o f th ree m ea su rem en ts w as ta
ken andlog con ve rte d fo r ana lys is . C h es t c ircum fe re
nce , b ia -c rom ia l an d b iil iac m ea surem en ts we re ta ke
n . T he
F rom the Depa rtm en ts o f M ed ic ine an d Comm un ityM ed ic
ine , U n iv e rs ity o f V e rm on t C o lleg e o f M ed ic in e
,Burlington. Vermont 05401 .
2 Supported by Pub lic H ea lth S erv ice G ran tsHS 00377 (D r.
G ibson ) a nd 5 RO l AM 13307 (D r.H o rto n ) an d a gran t from
th e V erm on t H eart A ssoc ia -t ion .
3Assoc ia te P ro fes so r o f M ed ic in e a nd Comm un
ityMedicine. A s so c ia te P ro fe sso r o f M ed ic in e . A s
-so c ia te P ro fe sso r o f C om m un ity M ed ic ine .
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- A GEU 40 -69
a..--_
10 0 0 so a 40 00 60 40 40FASTING PLA SM A IN SU L IN (p un i t
s /mi )
6O ( 141 )
AG E40 69 ( 144 )
so.
40
30-NO . IN
SAMPLE20 -
10-
2 H R POST GLUCOLA PLA SMA IN SUL IN(p unIts/m i)
1 3 8 8 G IBSON ET A L .
Ames Company , Elkhart, Indi ana.
follow ing indices se re used: I) The pondera l inde x
wasderived by dividing he ight in inches by cube root of thewe ight
in pounds. 2) P ercenta ge idea l we ight was ca lcu-la ted utiliz
ing the S ocie ty of Actua rie s build and bloodpressur e study
(21) . 3) P ercentage fa t by theaverage ofpredicte d va lue s of
percenta ge fa t corresponding tope rcentage overwe ight a nd
subscapula r skinfold (2 2 ). 4 )An androgynic score was ca lcula
te d based on the stra ightl in e d is cr im in a nt : 2 biacromial
width + 0.53 subischiallength - 0 .25 biiliac width - 81 =0(23 )
.
A s ingle blo od sa mple, drawn after fasting for am inimum of 8
hours, was used for chem ica l e stima tions.S ubjects were then
given 7 fluid ounces of G lucola conta ining 7 5 g carbohydra te
and ae cond blood samplecollected 2 hours la te r. Fa sting and
2-hour post-G lucolaplasma glucose we re measured by an auto-ana
lyzerfe rri- fe rrocyanide me thod. Fa sting and 2-hour post-G
lucola plasma insulin we re dete rm ined using a modifi-ca tion of
the double antibody radioimmunoassay te ch-nique of M organ and
Lazarow (2 4 ) w ith 51 pork insulintracer and human insulin standa
rds. The common loga-rithms of insulin concentra tions (pU /m I)
were used forana lysis of corre la tions and ca lcula tions of mean
insulinda ta . Fasting serum triglyce rides were measured by
theautomated fluorome tric me thod of Kessle r25 ) . Silicica cid
was used to remove phospholipids. The sta ndardused was triole in
and the coe fficie nt of va ria nce was6 .0 F asting serum chole
ste rols we re measured by theCa rr-D re kte r method (2 6 ) . The
standa rd used was N a-tiona l Bureau of S tanda rds purifie d
choleste rol a nd thecoe fficie nt of va ria nce was 3 .5
ResultsIn s u lin , ca rb o h yd ra te a n d lip id m e a n
s
F igure Ia and b illustra te the plasmainsulin da ta by sex both
for fasting and 2 -hourpost-G lucola insulin. F igure 2a and
showthe fasting and 2 -hour post-G lucola log in-sulin da ta . Log
transforma tion has been usedin orde r to de rive a norma l range
for our da tasince it is desirable to have a symmetrica
ldistribution curve for such a biologica l mea -surement. T he
means of the log insulin da tawere less than the means of the
untrans-formed da ta , indica ting a skew to the righttha t was e
lim ina ted by log transforma tion.T he norma l distribution of log
insulin concen-trations has been reported previously in se -lected
popula tions (7 , 27 , 28 ). Table I showsthe insulin, ca rbohydra
te and lipid da ta bro-ken down by decade . M ean fasting
insulinconcentra tions were not significantly diffe r-ent among the
va rious age groups in eithe rsex a lthough they were slightly
increased inthe fifth and sixth decades in women. The rewas no
significant sex diffe rence in meanfasting insulin concentra tion a
t any age . In
bF IG . I. a: S howing the distribution of fa sting
plasmainsulin in 1 41 men and 144om en ag ed 40-6 9 . Th e sk
ew
is a ppa re nt. b. Two-hour post-G lucola pla sma
insulindistribution in the same cohort.contrast, the 2 -hour post-G
lucola insulin con-centra tion was significantly highe r in
womenthan in men and the re was an increase withage in women but
little change in men.
The mean fasting glucose concentra tionwas not significantly
diffe rent in men andwomen and only a slight increase with
ad-vancing age was noted. Post-G lucola glucoseda ta were not
striking with the exception ofan unusua lly low 2-hour glucose
figure in menag e 5 0 - 5 9 and an increased va lue in womenage 60
-69 . The ca lcula tion of insulin-to-glucose ra tios added little
and re flected pri-marily the corresponding insulin concentra
-tions.
The re was no significant sex diffe rence in
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d AG E40 - 6 9
NO INSAMPLE
-1 -b LOG 25R POST G LU CO LA PLAS MA IN SU LIN jiunits/mI
IN S U LIN , GLUC O S E , LIP ID A N D AN THRO P OMETRIC D ATA
1389
mean choleste rol concentra tion and no clea r-cut change with
advancing age . The highestconcentra tions occurred in men age 50
-59and in women 60 -69 . T riglyce rides werehighe r in men than
women age 40 -59 , butthe re was a striking increase in the
womenage 60 -69 . H oweve r, because of w ide va ria -tion in
individua l va lues, these diffe rences a renot significant sta
tistica lly.A nthropom etric m eans
Table 2 shows the means for ce rta in an-thropometric da ta . T
riceps skinfolds wereremarkably consistent throughout the agegroups
in both sexes, but subscapula r skin-folds decreased with age in
men. The sum ofthe two skinfolds, an index of ove ra ll
obesity,declined slightly w ith age in men but did notchange in
women. The ra tio of subscapula r
F IG . 2 . a: Log fa sting plasma insulin indica ting
thenormaliza tion of the da ta . b: Log 2-hour post-G lucolaplasma
insulin distribution with sim ila r normaliza tion.
skinfold to triceps skinfold decreased withage in both men and
women. G ene ra l indicesof ove rwe ight declined in men with age
butstayed constant in women. An androgynicindex did not indica te
any pa rticula r a lte ra -tion in de rived somatotype in the va
rious agegroups.C orrelations bet w eeti an thropom e tricdata and
insulin
A corre la tion ma trix was ca lcula ted for theva riables
measured using da ta for the wholecohort subdivided by sex. T his
is shown inT able 3 . W e have established tha t onlyva lues with
significances a t the leve l of
