Ten-year weight gain is associated with elevated fasting insulin levels and precedes glucose elevation.
Level 4 - case-series / case-control
Cross-sectional survey analysis with retrospective weight recall
PubMed 29392827 · doi:10.1002/dmrr.2986
What was done
Using data from the US National Health and Nutrition Examination Survey (NHANES) 2011-2014, researchers analyzed 3,840 participants to evaluate the relationship between fasting insulin levels, insulin resistance (HOMA-IR), and 10-year weight change across glycemic stages. Participants were categorized into six groups based on fasting glucose and fasting insulin levels, with insulin dichotomized into normal (<25th percentile) and elevated (≥25th percentile).
What was found
Average 10-year weight change was higher in individuals with elevated fasting insulin compared to those in the first quartile (11.12 lbs vs 1.40 lbs, P < .0001). Across all groups, each 1 μU increase in fasting insulin was associated with a 0.52-pound weight increase (P < .0001), and each 1-unit increase in HOMA-IR was associated with a 1.32-pound weight increase (P < .0001). Marginal increases in weight were most pronounced in normal-insulin groups and diminished as glycemic stage progressed.
Why it matters
This study shows that fasting hyperinsulinemia and insulin resistance correlate with long-term weight gain before the onset of overt hyperglycemia, suggesting that hyperinsulinemia precedes glucose dysregulation in weight trajectory.
Limits
The cross-sectional survey design relies on retrospective self-reported weight history rather than longitudinal prospective measurements. The abstract does not report adjustments for diet, physical activity, or medication use, and the observational design cannot establish causality.
Cited by
- supports During the development of metabolic dysfunction, hyperinsulinemia emerges before fasting blood glucose levels become elevated.