社区体检人群血细胞比容与胰岛素抵抗的相关性研究

Relationship between Hematokrit and Insulin Resistance in Community Medical Groups

目的分析社区体检人群血细胞比容(hematokrit,HCT)与胰岛素抵抗(insulin resistance,IR)的相关性。方法选取2009年江苏省徐州地区在徐州市中心医院常规体检人群为研究对象,对符合要求的2033例体检者进行体格检查并抽取空腹血检测血细胞比容及各生化指标,计算胰岛素抵抗指数(homeostasis model assessment of insulin resistance,HOMA-IR),分析血细胞比容与胰岛素抵抗指数的关系。结果随着HCT的分位数增加,体重指数、血压、甘油三酯、总胆固醇、低密度脂蛋白、血清尿酸等代谢指标也随之增加,且差异有统计学意义。根据血细胞比容四分位值由低到高分组,校正性别、年龄、血脂后发现随着血细胞比容的升高,HOMA-IR依然呈逐渐上升趋势(P=0.008)。血细胞比容与体重指数存在交互作用并进一步对胰岛素抵抗产生影响(P=0.003),随着体重指数水平和血细胞比容的增加,胰岛素抵抗的发生率也是明显增加的。结论血细胞比容与胰岛素抵抗存在一定相关性,且独立于性别、年龄、体重指数、血压及血脂等因素。另外体重指数与血细胞比容存在交互作用,对两者之间的关系具有一定修饰性。

Objective To investigate the relationship between hematokrit and insulin resistance in a large Chinese cohort of commu- nity crowd. Methods We conducted a community - based health examination survey for individuals who were randomly selected from res- idents living in the urban area of Xuzhou, China, in 2009. A total of 2033 subjects were included in the present study. Physical measure- ments, hematokrit and biomarks were measured. Insulin Resistance was assessed by the homeostasis model assessment - insulin resistance （ HOMA - IR） index. Results The level of body mass index, blood pressure, triglycerides, total cholesterol, LDL, serum uric acid and other metabolic indicators increased following the increase of the level of HCT. And the difference was statistically significant. With the in- crease of HCT deposited quartile value from low to high group, HOMA - IR was still showed upward trend, even after adjusting for gen- der, age, lipids （ P = 0. 008）. HCT significantly interacted with body mass index to HOMA - IR（P = 0. 003 ）. With increasing of levels of body mass index and HCT, the number of cases of insulin resistance was also significantly increased. Conclusion Our data indicated that in apparently healthy Chinese adults, HCT was independently related to insulin resistance, even after adjusting for sex, age, body weight, blood pressure and lipids. In addition, body mass index interacted with HCT to affect insulin resistance. Body mass index may modify the association between HCT and insulin resistance.