胰岛素抵抗和超重与皮质醇及硫酸脱氢表雄酮水平的关系。

Relationship of insulin resistance and overweight with cortisol and dehydroepiandrosterone-sulfate levels.

作者信息

Mino Dolores, Amato Dante, Cuevas María Luisa, Fonseca María Eugenia, Búrbano Gabriel, Wacher Niels, Lifshitz Alberto

机构信息

Coordinación de Investigación Médica, División de Investigación Clínica, Mexico City, Mexico.

出版信息

Arch Med Res. 2002 Nov-Dec;33(6):524-30. doi: 10.1016/s0188-4409(02)00400-9.

DOI:10.1016/s0188-4409(02)00400-9

PMID:12505096

Abstract

BACKGROUND

Our objective was to assess the relationship of hormones such as cortisol and dehydroepiandrosterone-sulfate (DHEA-S) with insulin resistance and overweight.

METHODS

We designed and conducted a cross-sectional, observational survey consisting of home visits within a previously defined area of Mexico City. The study included 303 apparently healthy volunteers from a middle-class socioeconomic urban community. We measured glucose, cholesterol, triglycerides, insulin, cortisol, and DHEA-S. Insulin resistance (IR) was defined as belonging to the first quartile of fasting glucose/insulin ratio (G/IR) distribution or fourth quartile of IR (HOMA). Overweight was defined as body mass index (BMI) > or =25 kg/m(2).

RESULTS

To predict IR in women < or =35 years of age, principal component analysis (PCA) disclosed three components: 1) cholesterol, BMI, and diastolic blood pressure (DBP); 2) cholesterol, triglycerides, and cortisol, and 3) dehydroepiandrosterone-sulfate [DHEA-S]. Solely the latter (DHEA-S) was significantly associated with IR (odds ratio [OR] = 1.80, confidence interval 95% [CI 95%] 1.11-2.91, p = 0.015). For men < or =35 years of age, there were two components: 1) cholesterol, triglycerides, BMI, and DBP, and 2) DHEA-S, cholesterol, and cortisol. Component 1 was significantly associated with IR (OR = 5.65; CI 95% 1.62-19.65, p = 0.006). To predict overweight in women >35 years of age, there were three components, including 1) cholesterol and triglycerides, 2) cortisol, and 3) DHEA-S and G/IR. Component 2 was significantly associated with overweight (OR = 0.38, CI 95% 0.23-0.64, p = 0.000).

CONCLUSIONS

In women < or =35 years of age, high DHEA-S levels were associated with insulin resistance, which suggests that in young women DHEA-S exerts anti-estrogenic action, perhaps caused by its competitive binding with the estrogen receptor. Additionally, in women >35 years of age, low cortisol levels were associated with overweight. These associations were not identified for the male subgroup.

摘要

背景

我们的目标是评估皮质醇和硫酸脱氢表雄酮（DHEA-S）等激素与胰岛素抵抗和超重之间的关系。

方法

我们设计并开展了一项横断面观察性调查，包括在墨西哥城预先划定的区域内进行家访。该研究纳入了来自城市中产阶级社会经济社区的303名表面健康的志愿者。我们测量了血糖、胆固醇、甘油三酯、胰岛素、皮质醇和DHEA-S。胰岛素抵抗（IR）被定义为处于空腹血糖/胰岛素比值（G/IR）分布的第一个四分位数或胰岛素抵抗（HOMA）的第四个四分位数。超重被定义为体重指数（BMI）≥25 kg/m²。

结果

为预测35岁及以下女性的IR，主成分分析（PCA）揭示了三个成分：1）胆固醇、BMI和舒张压（DBP）；2）胆固醇、甘油三酯和皮质醇；3）硫酸脱氢表雄酮 [DHEA-S]。仅后者（DHEA-S）与IR显著相关（优势比 [OR] = 1.80，95%置信区间 [CI 95%] 1.11 - 2.91，p = 0.015）。对于35岁及以下男性，有两个成分：1）胆固醇、甘油三酯、BMI和DBP；2）DHEA-S、胆固醇和皮质醇。成分1与IR显著相关（OR = 5.65；CI 95% 1.62 - 19.65，p = 0.006）。为预测35岁以上女性的超重，有三个成分，包括1）胆固醇和甘油三酯；2）皮质醇；3）DHEA-S和G/IR。成分2与超重显著相关（OR = 0.38，CI 95% 0.23 - 0.64，p = 0.000）。