Influence of occupant collision state parameters on the lumbar spinal injury during frontal crash.

INTRODUCTION: Developed a detailed finite element model of spine and validated with the experimental or cadaveric tests to gain insight on occupant safety. OBJECTIVES: This study evaluates the influence of occupant collision state parameters such as height of the drop, occupant seating posture (occupant posture angle) and mass of the upper body on the risk of lumbar spinal injury during a frontal crash. METHODS: This parametric evaluation utilizing response surface methodology (RSM) performed. ANOVA was used to test the significance of parameters. RESULTS: Higher axial force of 3547 N is observed with higher dropping distance of 1500 mm. Similarly, higher strain and energy absorption were observed for the same dropping condition respectively. CONCLUSION: The result shows that all the factors considered in the experiment contribute to the risk of spinal lumbar injury during the frontal crash. Among all, height of the drop and the occupant posture angle are the most significant parameters in determining the lumbar spinal injury of occupant. It is observed that the injury criteria are directly proportional to the posture angle of the seat and height of drop.

Metabolic syndrome does not increase the risk of conversion of impaired glucose tolerance to diabetes in Asian Indians--Result of Indian diabetes prevention programme.

AIMS: In this study, we assessed for the prevalence of metabolic syndrome (MetS) in the cohort of subjects with impaired glucose tolerance (IGT) in the Indian Diabetes Prevention Programme and studied whether the syndrome enhanced the conversion to diabetes. METHODS: Effectiveness of lifestyle modification (LSM), metformin (Met) and LSM plus Met was tested in a randomised, controlled primary prevention study in subjects with IGT n=502 (M:W 397:105) at a median follow up of 30 months. Baseline prevalence of MetS was calculated using the WHO criteria. Insulin resistance (IR) was calculated using homeostasis model assessment (HOMA) method. RESULTS: MetS was present in 233 subjects (46.4%; 95% CI 41.9-50.9) in the total group, in men (n=168; 42.3%; 95% CI 37.4-47.3) and in women (n=65; 61.9%; 95% CI 51.9-71.2) (men versus women chi(2)=12.8, p=0.0005). Insulin resistance (HOMA-IR>or=4.1) was present in 69.1% with no gender difference. IR increased proportionately with increasing number of abnormalities, in IGT (39.8%), IGT plus one abnormality (56.5%) and IGT plus any two or more abnormalities (69.1%) (Mantel Haenszel chi(2)=22.8, p<0.0001). Incidence of diabetes was similar in subjects with (40.3%) (n=94/233) or without (40.1%) (n=108/269) MetS (p=0.97). Cox's regression analysis confirmed that MetS did not enhance the conversion rate of IGT to diabetes both in the control (HR=0.88, 95% CI 0.53-1.47, p=0.63) and in the total group (HR=1.02, 95% CI 0.78-1.35, p=0.88), after correcting for effects of intervention. CONCLUSION: Prevalence of MetS is high in Asian Indian IGT subjects, especially in women. However, it did not influence the rate of conversion of IGT to diabetes.

Parental influence on the spectrum of type 2 diabetes in the offspring among Indians.

AIM: Familial aggregation of type 2 diabetes and its vascular complications is strong in Indians. In this study, we have analysed whether the age of the parent at birth of the offspring had any influence on the age at diagnosis of diabetes and age at onset of microvascular complications in the diabetic offspring. METHODS: Families with either a type 2 diabetic father or mother and a type 2 diabetic offspring, all of whom had been tested at our centre were included in this study (n = 300, father--122, mother--178, offspring male --201, female--99). Anthropometric details, age at diagnosis of diabetes, age at onset of complications and duration of diabetes were recorded. All relevant clinical and investigatory tests were done and appropriate statistical analyses were done. RESULTS: Age at onset of diabetes was lower in the offspring than in their parents at least by a decade. The age at diagnosis of diabetes in the offspring was determined inversely by the age of the parent at childbirth (p<0.001) and positively by the age of onset of diabetes and the presence of complications in the parents (both p<0.0001). Moreover, the age at diagnosis of complications in the offspring were determined inversely by the age of the parent at childbirth (p=0.0001) and positively by the age of onset of complications in the parents (p=0.0009). DISCUSSION: A younger parental age at childbirth was protective to the offspring in that the offspring developed diabetes and the complications at an older age.

Effect of seaweed extracts on the growth and biochemical constituents of Vigna sinensis.

The effect of seaweed liquid fertilizers (SLF) of Sargassum wightii and Caulerpa chemnitzia on growth and biochemical constituents of Vigna sinensis was studied. The seeds soaked with aqueous extract of seaweeds performed better when compared to the water soaked controls. Hundred per cent germination was recorded both in aqueous extract soaked and water soaked treatments. The low concentration (20%) of aqueous extracts of S. wightii and C. chemnitzia promoted the seedling growth including the parameters of shoot length (15.87, 14.13 cm/seedling), root length (6.42, 5.38 cm/seedling), fresh weight (4.017, 4.012 g/seedling) and dry weight (0.878, 0.865 g/seedling), chlorophyll (1.599, 1.491 mg g-1 fr. wt.), carotenoids (0.899, 0.875 mg g-1 fr. wt.), protein content of shoot (3.956, 3.474 mg g-1 fr. wt.) and root (2.926, 2.890 mg g-1 fr. wt.), amino acid content of shoot (1.447, 1.429 mg g-1 fr. wt.) and root (0.698, 0.680 mg g-1 fr. wt.), reducing sugar content of shoot (6.426, 6.233 mg g-1 fr. wt.) and root (5.118, 5.103 mg g-1 fr. wt.), total sugar content of shoot (11.846, 11.350 mg g-1 fr. wt.) and root (10.368, 10.102 mg g-1 fr. wt.), alpha-amylase (1.927, 1.819 microg min-1 mg-1 protein) and beta-amylase (1.730, 1.617 microg min-1 mg-1 protein) activities in V. sinensis. Among the two seaweeds tested, S. wightii exhibited better responses.

Risk variables for coronary artery disease in Asian Indians.

No large study from India has addressed the association of risk variables with coronary artery disease (CAD) in angiographically proved cases. In this study, we analyzed the association of anthropometric variables, lipoproteins, and coagulation parameters with CAD in those cases proved by coronary angiography. A cross-sectional study of 447 men > or = 25 years old, classified as with CAD or without CAD, was performed. Men treated with aspirin or lipid-lowering agents, and those with renal, hepatic, or thyroid diseases were excluded. Associations of these variables with CAD were evaluated by univariate and multiple logistic regression analyses. The effect of diabetes on the CAD profile was also analyzed. Prevalences of diabetes and hypertension were significantly higher among those with CAD (p <0.001 for both). Lipid profile abnormalities, except lipoprotein (Lp(a)), were associated with CAD. Antibodies to oxidized low-density lipoprotein was higher in patients with CAD. Fibrinogen levels were higher in CAD, but plasminogen activator inhibitor-1 did not show an association with CAD. In the multiple logistic regression analysis, age, body mass index, very-low-density lipoprotein cholesterol, total to high-density lipoprotein cholesterol ratio, and fibrinogen showed significant independent association with CAD. Several lipid abnormalities were associated with CAD in Asian Indians, but no significant association was seen with Lp(a) levels.

Metabolic syndrome in urban Asian Indian adults--a population study using modified ATP III criteria.

AIMS/HYPOTHESIS: To determine the prevalence of the Metabolic syndrome (MetS) using modified ATP III criteria in urban Asian Indian adults. METHODS: 475 subjects (age 20-75 years) from a population data base were studied for the MetS using ATP III criteria but with a modified waist circumference (WC) appropriate for Indians. Presence of >or=3 of the following; raised WC (Men >or=90 cm, Women >or=85 cm), triglycerides (TG) >or=1.7 mmol/l), HDL-Cholesterol (HDL-C)-<1.0 mmol/l for men, <1.3 mmol/l for women, fasting plasma glucose (FPG)>or=6.1 mmol/l and blood pressure (BP)>or=130/>or=85 mm of Hg, or using BP medication, indicated the MetS. Insulin resistance (IR) was calculated using the Homeostasis Model Assessment (HOMA) equation. Factor analysis was used to identify clusters of correlated abnormalities. RESULTS: MetS was present in 41.1%. WC was increased in 31.4%, TG in 45.6%, low HDL-C in 65.5%, hypertension in 55.4% and raised FPG 26.7%. MetS was present in 27.9% of subjects with FPG<6.1 mmol/l and its prevalence increased to >70% with higher FPG values. MetS was more common in women than in men (46.5 vs. 36.4%, chi(2)=4.6, P=0.03) and in older people. Four distinct clusters of abnormalities were identified with some gender variations. IR was more prevalent in MetS and was a component of two clusters but it was not a core component in factor analysis. CONCLUSIONS: MetS is common in Asian Indians. Its prevalence is age-related, and is more common in women. HOMA-IR or fasting plasma insulin was not a core component of the MetS.

Postprandial hypertriglyceridaemia in treated type 2 diabetic subjects --the role of dietary components.

Postprandial hyperlipidaemia is a risk factor for cardiovascular diseases (CVD). This study was done (a) to evaluate whether postprandial hypertriglyceridaemia was common in Indian type 2 diabetic patients on treatment and (b) to see whether the high carbohydrate content of the diet was a cause of the lipid abnormality. Two hundred type 2 diabetic subjects (M:F, 137:63; mean age 51.6+/-10.2 years, mean BMI 25.5+/-3.1 kg/m(2)) with diabetes duration of 7.6+/-5.6 years were studied. Fasting and 2 h post prandial responses of plasma glucose and triglycerides (TG) were measured using a breakfast meal, usually consumed by the patient with the intake of usual hypoglycaemic drugs. Patients with a post prandial TG value greater than 15% of the corresponding fasting TG value were designated as group 2 and the remaining subjects as group 1. Dietary composition of the breakfast were calculated. Among the 200 subjects, 52 (26%) had post prandial TG higher than the fasting values. This was seen in patients who were consuming lower percentage of carbohydrates and higher percentage of fats than prescribed. Therefore the postprandial rise in TG was probably due to the high fat content of the diet and due to a lower insulin sensitivity. This study highlights the facts that postprandial hypertriglyceridaemia is seen only in a small proportion of the treated patients and the high carbohydrate diet does not produce hypertriglyceridaemia, either in the fasting or post prandial state. The minority who show an increased TG value at 2 h have been taking lower carbohydrate with higher fat content in the meal. This could have produced a lower insulin sensitivity in these patients.

Difference in body fat percentage does not explain the gender dimorphism in leptin in Asian Indians.

OBJECTIVE: Leptin is a hormone probably having regulatory function on energy intake and metabolic activities in humans. The study was done: (a) To determine the relation of leptin with the body fat% in Indians, (b) To see whether the differences in body fat accounted for the gender differences in the concentration of leptin and (c) to look for the effect of diabetes on the levels of leptin. METHODS: Glucose tolerance was determined by oral glucose tolerance test (GTT) in 87 subjects with no known history of diabetes. Leptin was estimated by radio immuno assay. Age, height, weight, waist and hip circumferences were noted. Body mass index (BMI, weight kg/height m2) and waist:hip ratio (WHR) were calculated. The body fat % was estimated by bioelectrical impedance analysis. RESULTS: Leptin correlated with log fat % and BMI, body weight and waist circumference in different categories of glucose tolerance (Pearson's correlation test). Leptin values were higher in women than in men even after correcting for the body fat % indicating that the gender dimorphism was not explained by the higher fat % in women. The geometric mean of leptin concentration in men was 3.6 ng/ml and in women 10.9 ng/ml (P < 0.0001). Leptin level were not influenced by the status of glucose tolerance. Gender showed a significant effect on leptin concentration (F = 11.0, df = 1.39, P = 0.002) after adjusting for the effect of covariates i.e. percentage of fat (log), BMI, age, WHR and 2 h plasma glucose by ANCOVA. None of the covariates except BMI (P < 0.0001) showed significant correlation with leptin. The total variance explained was 68.4%. CONCLUSION: We conclude that (1) Plasma leptin is strongly correlated to the body fat content (2) the gender dimorphism of leptin is not explained by the differences in fat percentage and (3) hyperglycemia does not influence plasma leptin levels.

Plasma homocysteine concentration and coronary artery disease in Asian Indians.

OBJECTIVE: This study was done (a) to evaluate the relationship between the plasma total homocysteine (tHcy) levels and coronary artery disease (CAD) in Asian Indians and (b) to see the relationship between tHcy and glucose intolerance. METHODS: Fasting concentrations of plasma tHcy was measured in 137 men, aged > or = 25 years who underwent coronary angiography while investigating for chest pain. Among them 71 had no CAD and 66 had CAD. Fasting plasma glucose (FPG) and glycosylated haemoglobin (HbA1c) were estimated. Total Hcy was measured using the Elisa method (Axis Biochemicals ASA-Oslo, Norway) in fasting EDTA plasma. RESULTS: The subjects with CAD were significantly older but had similar body mass index (BMI), waist-hip ratio (WHR), FPG and HbA1c values compared with the non-CAD subjects (P < 0.001). The median tHcy and the percentages of abnormal values were similar in non-CAD and CAD groups. No significant differences were seen in the four subgroups with respect to the mean tHcy or the percentage of abnormal values. The highest tHcy values were seen in the non-diabetic, non-CAD group (group 1--control). CONCLUSION: This preliminary data indicates that tHcy concentrations are not elevated in subjects with CAD and probably there is no association between total homocysteine and CAD in Indians. Homocysteine values were not influenced by the glucose tolerance status. Measurement of homocysteine concentrations may be more appropriate when the blood levels of vitamin B12 and folate are also measured.

Is increased apolipoprotein B-A major factor enhancing the risk of coronary artery disease in type 2 diabetes?

OBJECTIVES: An association of Apolipoprotein B (Apo B) with coronary artery disease (CAD) independent of LDL cholesterol (LDLc) concentrations has been reported in white population. This analysis was taken up to study whether the higher CAD risk in Asian Indians with diabetes could be explained by possible alterations in Apo B and Apolipoprotein A1 (Apo A1) concentrations. METHODS: The study group consisted of four hundred and forty seven men aged > or = 25 years, 167 with CAD and 280 with no CAD, classified by coronary angiography. Plasma lipid profile including total cholesterol, LDLc, Apo A1 and Apo B were done. Glucose tolerance was evaluated in all. RESULTS: Age, BMI, Apo B, and Apo A1 were significantly associated with CAD in a multiple regression analysis. Hyper Apo B was more common than hyper LDLc in CAD (73.6% vs 20.4%, chi2 = 157, P < 0.001). Apo B concentrations were increased in diabetic subjects even in the presence of normal levels of LDLc and in the absence of CAD. CONCLUSIONS: The study has shown that the apolipoproteins B and A1 provide better information regarding the risk of CAD. Apo B abnormalities exist in large percentages of CAD subjects despite having normal levels of LDLc. Diabetes per se enhances the Apo B concentrations and this could probably be one of the mechanisms of accelerated CAD in diabetes. Hyper Apo B may be an index of CAD risk.

Evaluation of hypoglycemic activity of inorganic constituents in Nelumbo nucifera seeds on streptozotocin-induced diabetes in rats.

The seeds of Nelumbo nucifera (Lotus) have been used in the traditional system of medicine for various ailments including diabetes. The present study was aimed at analyzing the levels of biologically important trace elements in the lotus seeds by atomic absorption spectroscopy and evaluating the hypoglycemic properties of seed ash on streptozotocin-induced diabetes in rats. Diabetic rats treated with lotus seed ash at a concentration of 200 mg/kg body weight orally for 30 days exhibited significant hypoglycemic activity. The presence of trace elements in appreciable amounts in the seeds may play a direct or indirect role on insulin secretion or its action in a synergetic manner. The hypoglycemic activity of the ash was comparable with glyclazide. The role of trace elements in disorders related to diabetes is also discussed briefly.

Insulin resistance alone does not explain the clustering of cardiovascular risk factors in southern India.

AIMS: To determine whether insulin resistance (IR calculated using the HOMA model) has a dominant role in the clustering of cardiovascular risk factors in the Asian Indian population. METHODS: A total of 654 non-diabetic subjects aged > or =40 years (male 396: female 258) were selected from a population survey. They had estimates of fasting and 2 h plasma glucose, insulin levels, body mass index (BMI), waist-to-hip ratio (WHR) and blood pressure. Factor analysis was carried out using the principle components analysis (PCA) with varimax orthogonal rotation of continuously distributed variables, considered to represent the components of insulin resistance syndrome including the calculated IR. RESULTS: There were three major clusters of cardiovascular disease (CVD) risk variables in men and four clusters in women. Insulin resistance, 2 h plasma glucose, insulin and obesity aggregated as the major domain. Insulin resistance was not linked with hypertension. BMI was a common link for all the three factors in men, and for three of the four in women. CONCLUSIONS: Insulin resistance is not the only underlying factor for the clustering of CVD risk factors in south Indians. These findings are consistent with the presence of several distinct physiological domains, as shown in other ethnic groups.

Insulin secretion and action show differences in impaired fasting glucose and in impaired glucose tolerance in Asian Indians.

BACKGROUND: The aim of the study was to compare the abnormalities in insulin secretion and insulin sensitivity in impaired fasting glucose (IFG) and in impaired glucose tolerance (IGT). METHODS: Glucose tolerance was determined by oral glucose tolerance test in 289 non-diabetic subjects selected for this study (M : F, 160 : 129, mean age 42.2 +/- 11.0 (SD) years, mean body mass index (BMI) 24.9 +/- 4.2 kg/m(2)). Diabetic subjects were excluded from the study. The association of insulin resistance and beta-cell function (calculated by HOMA model) with IFG and IGT was studied using linear and multiple logistic regression analyses. Subjects with normoglycaemia (NGT) were used as controls. RESULTS: Insulin resistance was significantly more in IFG and in IGT than in NGT. beta-cell dysfunction was significantly higher in IFG than in IGT. IFG was associated with both insulin resistance (OR = 9.11, p < 0.001) and beta-cell dysfunction (inverse correlation, OR = 0.103, p < 0.001), while only insulin resistance was significantly associated with IGT (OR = 1.24, p = 0.005). CONCLUSIONS: In urban South Asian Indians, IFG differed from IGT in having combined insulin resistance and beta-cell dysfunction, while IGT was associated only with insulin resistance.

Association of proinsulin and insulin resistance with coronary artery disease in non-diabetic south Indian men.

AIMS: To evaluate the association of plasma proinsulin and insulin resistance (IR) with coronary artery disease (CAD) in non-diabetic subjects. METHODS: In this case control study, 41 normoglycaemic men with angiographic evidence of CAD were compared with 41 control men matched for age and glycaemia and with no history or evidence of cardiac diseases. Estimations of plasma glucose, lipids, fasting plasma specific insulin (SI) and proinsulin (PI) were performed. IR was calculated by the homeostasis model assessment (HOMA) method. Multiple logistic regression analysis was performed to test the association of the variables with the prevalence of CAD. RESULTS: Subjects with CAD had a higher body mass index (BMI) (25.4 +/- 4.3 vs. 22.9 +/- 3.2 kg/m2, P = 0.003) and waist to hip ratio (WHR) (0.95 +/- 0.05 vs. 0.89 +/- 0.09, P = 0.001) and a lower high-density lipoprotein (HDL) cholesterol level (0.97 +/- 0.2 vs. 1.1 +/- 0.2 mmol/l, P = 0.002). They also had higher mean SI values (107.5 vs. 62.3 pmol/l, P = 0.002), PI values (19.3 vs. 5.7 pmol/l, P < 0.0001), PI/SI ratios (21.4 vs. 10.3, P < 0.0001) and HOMA IR (4.2 vs. 2.4, P = 0.004) compared with non-CAD subjects. These variables were associated with CAD in the unadjusted multiple regression analysis. In the multiple regression with the forward entry of the variables, WHR and PI only showed independent association with CAD. CONCLUSIONS: Subjects with CAD had higher levels of obesity and WHR. CAD showed an association with low HDL cholesterol, circulating PI, PI/SI ratios and IR.

Cosegregation of obesity with familial aggregation of type 2 diabetes mellitus.

OBJECTIVE: We have shown that a positive family history of diabetes, and the variables of general and central obesity are independent risk factors for type 2 diabetes in our population. This study was done to evaluate whether a familial predisposition to diabetes resulted in a tendency for adverse anthropometric and haemodynamic profiles in south Indian non-diabetic subjects. METHODS: The analysis was carried out on 2463 subjects (M: F, 1196: 1267) with normal glucose tolerance (NGT). The study subjects were selected from population surveys for diabetes. Details of age, sex, family history of diabetes, body mass index (b.m.i.), waist-to-hip ratio (WHR) and blood pressure were recorded. Serum cholesterol and triglycerides were estimated. RESULTS: A positive family history of diabetes was present in 24.7% of our subjects. Mean b.m.i. and percentage of obesity were significantly higher in families with a positive family history (group 2) vs. families with no family history (group 1). Subjects in group 2 had a higher 2-h plasma glucose (p < 0.001) and higher prevalence of hypertension (chi2 = 6.91, p = 0.0086). Factor analysis with principle components analysis (PCA) showed that a family history of diabetes clustered with WHR in men, and with b.m.i. and WHR in women. The b.m.i. formed a different domain with blood pressure in both sexes. WHR and b.m.i. clustered with cholesterol and triglycerides in another domain. CONCLUSIONS: In this population, general and central obesity are associated with a family history of diabetes. A family history of diabetes may increase the risk of hypertension and hyperlipidaemia indirectly through its connection with b.m.i.

Insulin secretion and action in different stages of glucose tolerance in Asian Indians.

AIMS: To evaluate the sequence of changes in insulin secretion and action in different stages of glucose tolerance and the effect of obesity on insulin profile in South Indian adults. Blood samples from 260 consecutive cases with no known history of diabetes were collected. Plasma insulin levels were measured during a 75-g oral glucose tolerance test. Insulin resistance (IR) was calculated, using the homeostasis model assessment (HOMA). An index of insulin secretion was derived as the ratio of incremental insulin at 30 min divided by 30 minute plasma glucose (delta I/G). RESULTS: Normoglycaemia was present in 164, impaired glucose tolerance (IGT) in 60 and diabetes in 36 subjects. Fasting and 2 h insulin secretion showed bell shaped curves with increasing plasma glucose. The peak values corresponded to the cut-off values used for the diagnosis of clinical diabetes. IR was higher in obese than in nonobese, nondiabetic subjects but the effect of obesity on IR was not found in subjects with diabetes. IGT was associated with higher IR, but not with evidence of a beta-cell defect. CONCLUSIONS: Evaluation of insulin resistance and beta-cell function in different stages of glucose tolerance indicate that insulin resistance is manifested in the early stage of glucose intolerance in South Indians, i.e. IGT. A beta-cell defect was mostly found in people with diabetes. The beta-cell defect is more common in diabetes among the nonobese.

Lack of association of insulin resistance and carotid intimal medial thickness in non-diabetic Asian Indian subjects.

OBJECTIVE: Atherosclerosis is associated with insulin resistance (IR) and dyslipidaemia. Impaired glucose tolerance (IGT) is characterised by IR and is associated with a higher risk of atherosclerosis. The objective of the present study was to test whether early atherosclerosis indicated by intimal medial thickness (IMT) of common carotid artery (CCA) and internal carotid artery (ICA) is higher in IGT than in normoglycaemic subjects (NGT) and to look for an association of IMT with IR and dyslipidaemia. STUDY DESIGN AND METHODS: Ninety-nine randomly selected non-diabetic subjects aged >or=35 years (48 NGT and 51 IGT) were studied. Measurements of body mass index (BMI), waist/hip ratio (WHR), blood pressure, cholesterol-total, HDL, LDL, VLDL, triglycerides (TG), lipoprotein (a), apolipoprotein-A1 (Apo A1) and apolipoprotein-B (Apo B) and ratio of Apo A1/Apo B were estimated. Insulin resistance (HOMA-IR) was calculated using the fasting plasma insulin and glucose values. IMT of CCA and ICA were measured using high-resolution beta-mode ultrasonography. RESULTS: Subjects with IGT and NGT were matched for BMI and WHR; HOMA-IR was higher in IGT vs NGT (7.92+/-4.2 vs 6.07+/-3.76, p = 0.028). Age-adjusted IMT values were similar in NGT and IGT (CCA 0.59+/-0.17 and 0.63+/-0.22 mm and ICA 0.44+/-0.10 and 0.45+/-0.10 mm, respectively). Further analyses were done in the total group. Multiple linear regression analyses showed that CCA-IMT was significantly associated with age and negatively associated with Apo A1/Apo B ratio. ICA-IMT was associated with age only. IMT was significantly correlated with cholesterol-total and LDL-cholesterol and apolipoproteins. It was not associated with IR. CONCLUSION: In southern Indians, IGT did not influence the IMT. Although insulin resistance was higher in IGT, it was not associated with higher IMT. Conventional risk factors such as cholesterol, LDL-cholesterol and apolipoproteins showed association with IMT in the insulin-resistant population.