Possible Direct Influence of Complement 3 in Decreasing Insulin Sensitvity in a Cohort of Overweight and Obese Subjects
Giovanni De Pergola, Massimo Tartagni, Nicola Bartolomeo, Irene Bruno, Michele Masiello, Domenico Caccavo, Serena Bavaro and Franco Silvestris
Affiliation: Clinical Nutrition Unit, Medical Oncology, Department of Biomedical Sciences and Human Oncology, Section of Clinical Oncology, University of Bari, School of Medicine, Policlinico, Piazza Giulio Cesare 11, 70124 Bari, Italy.
A group of 608 apparently healthy patients, 136 men and 472 women, either overweight or obese, aged 18-69
years, were examined. BMI, waist circumference, fasting blood glucose (FBG), insulin, and complement 3 (C3) serum
levels were measured; the homeostasis model assessment (HOMAIR) was used to evaluate insulin resistance; and physical
activity was quantified by a questionnaire.
Results: HOMAIR showed a positive correlation with BMI (r: 0.478, p < 0.001), waist circumference (r: 0.487, p < 0.001),
and C3 (r: 0.445, p < 0.001). Moreover, it was significantly associated with gender (F Fisher = 22.12, p < 0.001), and the
mean HOMAIR levels were significantly different among the three groups of physical activity, with the lowest level of
insulin resistance at the highest level of physical activity (F=7,31, p < 0.001). A multiple regression analysis was carried
out with HOMAIR as the dependent variable and gender, age, BMI, waist circumference, C3 and the level of physical
activity as independent variables (fitted model: F = 41.24, P<0.001, R2 = 0.328). HOMAIR maintained an independent
association with C3 (β = 0.678, P<0.001), sex (β = 0.189, P<0.001), BMI (β = 0.637, P<0.01), and age (β = -0.004,
Conclusions: This study of a cohort of overweight and obese subjects has shown that insulin resistance (dependent
variable) is positively associated with C3 serum levels, independently of age, gender, anthropometric parameters and
physical activity, suggesting that higher C3 serum levels may directly increase insulin resistance in obesity.
Keywords: Body fat distribution, complement 3, gender, inflammation, insulin, obesity, physical activity.
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