Lee Z S, Critchley J A, Chan J C, Anderson P J, Thomas G N, Ko G T, Young R P, Chan T Y, Cockram C S, Tomlinson B
Divisions of Clinical Pharmacology and Endocrinology, Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong.
Hong Kong Med J. 2000 Mar;6(1):13-23.
To examine the interrelationships between obesity and various cardiovascular risk factors, and to investigate the relative importance of insulin and obesity in their associations with various pathophysiologies.
Cross-sectional clinic-based study.
Medical clinics at a university teaching hospital, Shatin, Hong Kong.
A heterogeneous cohort of 767 Hong Kong Chinese subjects with a mean age of 43 (standard deviation, 14) years.
Body mass index, waist circumference, plasma insulin, insulin resistance index, fasting plasma glucose and lipid levels, blood pressure, and 24-hour urinary albumin excretion.
Pathophysiological abnormalities and risk factors are frequently clustered to varying degrees. Compared with the control subjects, patients with at least one component of the metabolic syndrome were more obese, hyperinsulinaemic, insulin resistant, hyperglycaemic, hypertensive, dyslipidaemic, and albuminuric (all variables, P<0.001). Increasing degrees of body mass index, waist circumference, plasma insulin level, and insulin resistance index were associated with an increasing number of risk factors after adjusting for age and sex (all variables, P<0.02). Multiple regression analysis showed that obesity, as reflected by either the body mass index or waist circumference, had a closer association than plasma insulin with the fasting plasma glucose concentration, blood pressure, and high-density lipoprotein-cholesterol and triglyceride concentrations. Using 19.0-20.9 kg/m(2) as the reference body mass index interval, the lowest cardiovascular risk was associated with a body mass index of <23.0 kg/m(2). There was an increased risk of 3.1 and 5 times when the body mass index was 23. 0-24.9 kg/m(2) and > or =25 kg/m(2), respectively.
Obesity, hyperinsulinaemia, and insulin resistance are characteristic features of Hong Kong Chinese patients who have various components of the metabolic syndrome. Obesity has a greater effect than plasma insulin on various pathophysiologies.
研究肥胖与多种心血管危险因素之间的相互关系，并探讨胰岛素和肥胖在与各种病理生理状况的关联中相对重要性。
基于门诊的横断面研究。
香港沙田一所大学教学医院的诊所。
767名香港华裔受试者组成的异质性队列，平均年龄43岁（标准差14岁）。
体重指数、腰围、血浆胰岛素、胰岛素抵抗指数、空腹血糖和血脂水平、血压以及24小时尿白蛋白排泄量。
病理生理异常和危险因素经常不同程度地聚集。与对照组相比，患有代谢综合征至少一种组分的患者更肥胖、高胰岛素血症、胰岛素抵抗、高血糖、高血压、血脂异常和蛋白尿（所有变量，P<0.001）。在调整年龄和性别后，体重指数、腰围、血浆胰岛素水平和胰岛素抵抗指数的增加程度与危险因素数量的增加相关（所有变量，P<0.02）。多元回归分析表明，体重指数或腰围所反映的肥胖与空腹血糖浓度、血压、高密度脂蛋白胆固醇和甘油三酯浓度的关联比血浆胰岛素更密切。以19.0 - 20.9 kg/m²作为参考体重指数区间，心血管风险最低与体重指数<23.0 kg/m²相关。当体重指数为23.0 - 24.9 kg/m²和≥25 kg/m²时，风险分别增加3.1倍和5倍。
肥胖、高胰岛素血症和胰岛素抵抗是患有代谢综合征各种组分的香港华裔患者的特征。肥胖对各种病理生理状况的影响比血浆胰岛素更大。
