胰岛素抵抗在非糖尿病女性中与血管性血友病因子水平升高有关：一项对2型糖尿病患者后代与非糖尿病患者后代的研究。

Insulin resistance is accompanied by increased von Willebrand factor levels in nondiabetic women: a study of offspring of type 2 diabetic subjects compared to offspring of nondiabetic subjects.

作者信息

Foss C H, Vestbo E, Frøland A, Ingerslev J, Gjessing H J, Mogensen C E, Damsgaard E M

机构信息

Medical Department M, Diabetes and Endocrinology, Aarhus Kommunehospital, Aarhus University Hospital, Aarhus, Denmark.

出版信息

J Intern Med. 2002 Aug;252(2):155-63. doi: 10.1046/j.1365-2796.2002.01024.x.

DOI:10.1046/j.1365-2796.2002.01024.x

PMID:12190891

Abstract

OBJECTIVES

To examine whether levels of von Willebrand factor (vWF), fibrinogen and fibronectin are related to a parental history of type 2 diabetes and to determine possible explanatory factors for high versus low vWF and fibrinogen.

DESIGN

Cross-sectional study.

SUBJECTS, MAIN OUTCOME MEASURES: We compared vWF, fibrinogen and fibronectin in 88 nondiabetic offspring of type 2 diabetic subjects (relatives) and 103 offspring of nondiabetic subjects (controls). Other measurements included urinary albumin excretion rate, blood pressure, lipid profile and insulin resistance using homeostasis model assessment (HOMAIR).

RESULTS

There were no significant differences in vWF (1.12 vs. 1.06 IU x mL(-1), P = 0.296), fibrinogen (3.2 vs. 3.1 g x L(-1); P = 0.263) or fibronectin (0.39 vs. 0.40 g x L(-1), P = 0.448) between relatives and controls. With multiple logistic regression we determined explanatory factors for high versus low vWF and fibrinogen. Age (P < 0.01), urinary albumin excretion rate (P < 0.05), ischaemic heart disease (IHD) (P < 0.05) were found to be significant explanatory factors for vWF above the median (1.10 IU x mL(-1)). Interaction between insulin resistance and sex was found. Odds ratio for high versus low insulin resistance was 18.39 (P < 0.001) for women and 1.92 (P = 0.32) for men. Body mass index (BMI) (P < 0.05), sex (P < 0.01), smoking status (P < 0.05) and IHD (P < 0.01) were significant explanatory factors for fibrinogen above the median (3.1 g x L(-1)).

CONCLUSIONS

Levels of vWF, fibrinogen and fibronectin were not influenced by a parental history of type 2 diabetes. Insulin resistance was found to be a significant risk indicator for high vWF only in women. This may indicate that insulin resistance is a higher risk factor for women than for men, when the outcome is endothelial dysfunction possibly resulting in overt cardiovascular disease.

摘要

目的

研究血管性血友病因子（vWF）、纤维蛋白原和纤连蛋白水平是否与2型糖尿病家族史相关，并确定vWF和纤维蛋白原高低的可能解释因素。

设计

横断面研究。

研究对象、主要观察指标：我们比较了88名2型糖尿病患者的非糖尿病后代（亲属）和103名非糖尿病患者的后代（对照组）的vWF、纤维蛋白原和纤连蛋白。其他测量指标包括尿白蛋白排泄率、血压、血脂谱以及使用稳态模型评估（HOMAIR）法测定的胰岛素抵抗。

结果

亲属组与对照组在vWF（1.12对1.06 IU×mL⁻¹，P = 0.296）、纤维蛋白原（3.2对3.1 g×L⁻¹；P = 0.263）或纤连蛋白（0.39对0.40 g×L⁻¹，P = 0.448）方面无显著差异。通过多元逻辑回归，我们确定了vWF和纤维蛋白原高低的解释因素。年龄（P < 0.01）、尿白蛋白排泄率（P < 0.05）、缺血性心脏病（IHD）（P < 0.05）被发现是vWF高于中位数（1.10 IU×mL⁻¹）的显著解释因素。发现胰岛素抵抗与性别之间存在相互作用。女性高胰岛素抵抗与低胰岛素抵抗的比值比为18.39（P < 0.001），男性为1.92（P = 0.32）。体重指数（BMI）（P < 0.05）、性别（P < 0.01）、吸烟状况（P < 0.05）和IHD（P < 0.01）是纤维蛋白原高于中位数（3.1 g×L⁻¹）的显著解释因素。