Resnick Helaine E, Bergman Richard N, Henderson Jeffrey A, Nez-Henderson Patricia, Howard Barbara V
MedStar Research Institute, Washington, DC, USA.
Ethn Dis. 2002 Fall;12(4):523-9.
Cross sectional
Community
Sixty-one Al participants in SHS MAIN OUTCOME MEASURES: Mean SI measured by FSIGT, a complex protocol to evaluate insulin sensitivity, and mean IR measured by the HOMA model, a method based on measures of fasting glucose and fasting insulin.
Although 70% of sample participants were non-diabetic, only 18% were insulin sensitive by SI. Diabetes status strongly confounded Si among Al in SHS. At non-diabetic levels of fasting glucose (< 126 mg/dL), SI correlated well with HOMA IR (rho = -0.49, P = .0009), but SI did not reflect HOMA IR at levels of fasting glucose that are diagnostic of diabetes (> or = 126 mg/dL; rho = -0.13, P = n.s.). With the exception of some Hispanic participants in IRAS, mean SI of non-diabetic Al in SHS was lower than that of their non-diabetic IRAS counterparts. Diabetic Al participants in SHS had markedly lower mean SI than all diabetic participants in IRAS.
The HOMA model may be a useful tool to identify non-diabetic American Indians who might benefit from early CVD risk factor modification.
（1）在美国印第安人样本中，确定通过频繁采样静脉葡萄糖耐量试验（FSIGT）测量的胰岛素敏感性（SI）与通过稳态模型评估（HOMA）模型测量的更简单的胰岛素抵抗（IR）指标之间的相关性；（2）在强心研究（SHS）中比较糖尿病和非糖尿病美国印第安人样本的胰岛素敏感性与胰岛素抵抗动脉粥样硬化研究（IRAS）中的白人、黑人和西班牙裔美国人的胰岛素敏感性。
横断面研究
社区
SHS中的61名美国印第安人参与者
通过FSIGT测量的平均SI（一种评估胰岛素敏感性的复杂方案）和通过HOMA模型测量的平均IR（一种基于空腹血糖和空腹胰岛素测量的方法）。
尽管样本参与者中有70%是非糖尿病患者，但通过SI评估只有18%的人胰岛素敏感。糖尿病状态在SHS的美国印第安人中严重混淆了SI。在空腹血糖处于非糖尿病水平（<126mg/dL）时，SI与HOMA-IR相关性良好（rho=-0.49，P=0.0009），但在空腹血糖达到糖尿病诊断水平（≥126mg/dL）时，SI不能反映HOMA-IR（rho=-0.13，P=无统计学意义）。除了IRAS中的一些西班牙裔参与者外，SHS中未患糖尿病的美国印第安人的平均SI低于IRAS中相应的未患糖尿病者。SHS中患糖尿病的美国印第安人参与者的平均SI明显低于IRAS中所有患糖尿病的参与者。
HOMA模型可能是一种有用的工具，可用于识别可能从早期心血管疾病风险因素调整中获益的非糖尿病美国印第安人。
