De Pergola G, Pannacciulli N, Zamboni M, Minenna A, Brocco G, Sciaraffia M, Giorgino R
Department of Emergency and Transplant, University of Bari, Italy.
Diabetes Nutr Metab. 2001 Oct;14(5):253-8.
The aim of the present study was to examine the relationship of homocysteine (Hcy) plasma levels to insulin resistance (IR).
A cross-sectional study in a primary care setting.
Fasting Hcy levels were measured in the plasma of 44 pre-menopausal women [17 normal weight (body mass index BMI 20.0-24.9 kg/m2), 7 overweight (BMI 25.0-29.9 kg/m2), 20 obese (BMI> or =30.0 kg/m2)], aged 18-45 yr. Other measurements included: central fat accumulation, as evaluated by waist circumference; IR, as calculated by homeostatic model assessment (HOMAIR); systolic and diastolic blood pressure; and fasting concentrations of glucose, insulin and lipids (total cholesterol, HDL-cholesterol, triglycerides).
Hcy was positively correlated with insulin concentrations (p<0.01), HOMAIR (p<0.01), and systolic and diastolic blood pressure (p<0.01 and p<0.05, respectively). After multivariate analysis, only HOMAIR maintained an independent association with Hcy (p<0.05), irrespective of age and other anthropometric and biochemical variables. Lastly, we observed a gradual increase in Hcy plasma levels across the age- and BMI-matched quartiles in which the whole population was divided according to HOMAIR levels (F: 2.73, p<0.05 for linear trend).
Our study shows that Hcy plasma levels are independently associated with IR in apparently healthy normal weight, overweight and obese pre-menopausal women, thus suggesting a possible role of IR and/or hyperinsulinaemia in increasing Hcy plasma levels. Since Hcy is a well-known cardiovascular risk factor, higher Hcy plasma levels may well be a further mechanism explaining the higher risk of coronary heart disease in patients affected by IR.
本研究旨在探讨血浆同型半胱氨酸（Hcy）水平与胰岛素抵抗（IR）之间的关系。
在基层医疗环境中进行的横断面研究。
对44名年龄在18 - 45岁的绝经前女性的血浆进行空腹Hcy水平检测[17名体重正常（体重指数BMI 20.0 - 24.9 kg/m²），7名超重（BMI 25.0 - 29.9 kg/m²），20名肥胖（BMI≥30.0 kg/m²）]。其他测量指标包括：通过腰围评估的中心性脂肪堆积；通过稳态模型评估（HOMAIR）计算的IR；收缩压和舒张压；以及空腹血糖、胰岛素和血脂（总胆固醇、高密度脂蛋白胆固醇、甘油三酯）浓度。
Hcy与胰岛素浓度（p<0.01）、HOMAIR（p<0.01）以及收缩压和舒张压（分别为p<0.01和p<0.05）呈正相关。多变量分析后，无论年龄以及其他人体测量和生化变量如何，只有HOMAIR与Hcy保持独立关联（p<0.05）。最后，我们观察到根据HOMAIR水平将整个人群划分的年龄和BMI匹配四分位数中，Hcy血浆水平逐渐升高（F：2.73，线性趋势p<0.05）。
我们的研究表明，在明显健康的体重正常、超重和肥胖的绝经前女性中，Hcy血浆水平与IR独立相关，这表明IR和/或高胰岛素血症在升高Hcy血浆水平方面可能起作用。由于Hcy是众所周知的心血管危险因素较高的Hcy血浆水平很可能是解释IR患者冠心病风险较高的另一种机制。
