Hedblad B, Nilsson P, Janzon L, Berglund G
Department of Medicine, Lund University, Malmö University Hospital, Sweden.
Diabet Med. 2000 Apr;17(4):299-307. doi: 10.1046/j.1464-5491.2000.00280.x.
To assess whether there is an association between insulin resistance and carotid intima-media thickness and stenosis in non-diabetic subjects free from symptomatic cardiovascular disease.
A cross-sectional population-based study in Malmö, Sweden, of 4,816 (40% men) subjects, born 1926-1945. The prevalence of insulin resistance was established by the homeostasis model assessment (HOMA) and defined as values above the 75th percentile. Criteria issued by the European Group for the Study of Insulin Resistance (EGIR) were used for the definition of the insulin resistance syndrome. Common carotid artery intima-media thickness (IMT) and carotid stenosis (> 15%) were measured by B-mode ultrasonography.
Age and sex-adjusted common carotid IMT among subjects with the insulin resistance syndrome (12.7%) and controls was 0.812 mm, respectively, 0.778 mm (P < 0.001). The prevalence of stenosis in the two groups was 22.9 and 19.2% (P = 0.040). Insulin resistance per se was after adjustment for age and sex associated with increased IMT (0.780 mm vs. 0.754 mm, P < 0.001). This association disappeared, however, when other factors included in the insulin resistance syndrome were taken into account.
Fasting serum insulin covaries with a number of factors and conditions known to influence the development of atherosclerosis. It is concluded that the association between insulin resistance, as assessed by the HOMA method in non-diabetic subjects, and atherosclerosis is explained by its covariance with established risk factors for cardiovascular disease of which hypertension seems to be the most significant.
评估在无心血管疾病症状的非糖尿病受试者中，胰岛素抵抗与颈动脉内膜中层厚度及狭窄之间是否存在关联。
在瑞典马尔默进行的一项基于人群的横断面研究，纳入了4816名受试者（40%为男性），出生于1926年至1945年。通过稳态模型评估（HOMA）确定胰岛素抵抗的患病率，并将其定义为高于第75百分位数的值。采用欧洲胰岛素抵抗研究组（EGIR）发布的标准来定义胰岛素抵抗综合征。通过B型超声测量颈总动脉内膜中层厚度（IMT）和颈动脉狭窄（>15%）。
胰岛素抵抗综合征患者（12.7%）和对照组经年龄和性别调整后的颈总动脉IMT分别为0.812mm和0.778mm（P<0.001）。两组的狭窄患病率分别为22.9%和19.2%（P = 0.040）。在调整年龄和性别后，胰岛素抵抗本身与IMT增加相关（0.780mm对0.754mm，P<0.001）。然而，当考虑胰岛素抵抗综合征中包含的其他因素时，这种关联消失了。
空腹血清胰岛素与许多已知会影响动脉粥样硬化发展的因素和状况相关。得出结论，在非糖尿病受试者中通过HOMA方法评估的胰岛素抵抗与动脉粥样硬化之间的关联，是由其与已确立的心血管疾病危险因素的共变关系所解释的，其中高血压似乎是最显著的因素。
