胰岛素抵抗与冠心病危险因素的关系

Insulin resistance is associated with a cluster of risk factors of coronary artery disease

我们分析了２６４例非糖尿病病人［糖耐量低减（ＩＧＴ）１４９例，口服糖耐量试验（ＯＧＴＴ）正常者１１５例］的胰岛素敏感性与动脉粥样硬化性心脏病危险因素：高血压、ＩＧＴ、高甘油三酯血症和低高密度脂蛋白胆固醇血症的关系。有上述一项、二项及三项以上异常者分别为９１例、６７例及３０例，余７６例无上述任何异常。当危险因素数目从０增至≥３时，胰岛素相对敏感性逐渐下降：１，０．７５，０．５６，０．４６；空腹（ＦＩＮＳ）及服糖后２小时（ＩＮＳ２Ｈ）胰岛素渐增分别为：ＦＩＮＳ：１４．１、１７．４、２０．８及２５．７ｍＵ／Ｌ，ＩＮＳ２Ｈ４９．１、７４．０、１０２．８及１４１．９ｍＵ／Ｌ；血糖水平也增加。多因素线性回归分析显示调整年龄、性别影响后，这种关系依然存在。结果提示胰岛素抵抗与冠心病危险因素的＂聚集＂程度密切相关。

Abstract The relationship between insulin sensitivity and a cluster of cardiovascular risk factors including hypertension, impaired glucose tolerance, hypertriglyceridemia and low serum HDL-cholesterol level was investigated.Among the 264 nondiabetic subjects, 76 had none of the above mentioned risk factors, 91 had one, 67 had two and 30 had three or four risk factors. Pearson correlation analysis showed that the index of insulin sensitivity correlated negatively with systolic blood pressure, diastolic blood pressure, serum triglyceride and cholesterol,BMI, but positively with HDL-cholesterol. As the number of risk facters increased from 0 to ≥3, the relative insulin sensitivity progressively decreassed (1, 0. 75,0. 56, and 0. 46, respectively), while the fast and 2 hour plasma insulin and plasma glucose levels increased progressively [FINS (mU/L) : 14. 1 , 17. 4, 20. 8 and 25. 7; INS 2h: 49. 1, 74. 0, 102. 8 and 141. 94 FPG (mmol/L): 4. 65, 5. 07, 5. 67 and 5. 63;PG 2h: 4.95, 7. 59, 8. 67 and 9. 04, respectively]. Multivariate analysis demonstrated that after adjustment of age and sex, the relationships still existed. The results indicated that insulin resistance is associated with a cluster of risk factors of coronary artery diesease.