胰岛素原、真胰岛素与冠心病危险因素的关系

Relationship of proinsulin and true insulin to cardiovascular risk factors in non-diabetic subjects

目的 探讨胰岛素原 (PI)、真胰岛素 (TI)是否与冠心病危险因素相关。方法 采用BA ELISA法测定 119例入选者口服葡萄糖耐量试验 (OGTT)各时相的PI、TI水平 ,并与冠心病危险因素及其数目作相关分析。结果 空腹及糖负荷 2hPI、TI与冠心病危险因素数目 (r =0 19～ 0 33)、体重指数 (BMI) (r =0 2 3～ 0 41)及WHR(r =0 32～ 0 5 1)呈正相关 ,而与HDL C(r =- 0 2 2～ - 0 30 )负相关 ;空腹PI及 2h糖负荷PI、TI与高血压 (r=0 18～ 0 2 0 )、葡萄糖耐量减低 (IGT) (r =0 13～ 0 34 )、TG(r=0 32～ 0 33)和尿酸 (r=0 2 7～ 0 36 )呈正相关 ,空腹及 2hPI与apoB(r =0 2 6 )呈正相关 ,2hPI与TC(r=0 2 1)及家族史 (r=0 2 1)呈正相关 ;经校正年龄、性别、BMI、WHR(腰臀比值 )、空腹及 2h血糖后 ,TI与血脂的关系消失 ,PI与血脂的关系减弱 :空腹PI与TG(r=0 32 )、apoB (r=0 19)及尿酸 (r =0 2 2 )呈正相关 ,2hPI与apoB(r=0 2 7)及尿酸 (r=0 2 0 )正相关 ,与HDL C (r=- 0 2 1)呈负相关 ;多元逐步回归分析法亦显示PI与血脂的关系比TI更密切。结论 PI、TI与冠心病危险因素有明显关系 。

Objective To explore whether proinsulin (PI) and true insulin (TI) are related to cardiovascular risk factors. Methods PI and TI levels of 119 subjects during 2 h 75 g OGTT after an overnight 14 h fast were detected by BA ELISA in which proinsulin crossreactivity is less than 0.1%. The relationship between PI, TI levels and traditional cardiovascular risk factors was assessed by spearman correlation, partial corrclation and multiple regression analysis. Results Fasting and 2h PI, TI were positively related to the number of traditional cardiovascular risk factors ( r =0 19-0 33), BMI ( r =0 23-0 41) and WHR ( r =0 32-0 51), negatively related to HDL C ( r =-0 22- -0 30). Fasting PI and 2h PI, TI were positively associated with IGT ( r =0 13-0 34), hypertension ( r =0 18-0 20), UA ( r =0 27-0 36) and TG ( r =0 32-0 33), fasting and 2h PI were positively related to apolipoprotein B ( r =0 26), 2h PI was also positively related to TC ( r =0 22); but after adjusting for age, sex, BMI, WHR, fasting and 2h blood glucose, the relationship between TI and blood lipids disappeared, the relationship between PI and blood lipids weakened or disappeared. In multiple regression analyses, PI level was more strongly associated with triglycerides, total cholesterol and apolipoprotein B than TI level. Conclusion PI and TI, whether fasting or post glucose loading, are closely related to cardiovascular risk factors.