Vaccaro Olga, Cardoni Ondina, Cuomo Vincenzo, Panarelli Walter, Laurenzi Martino, Mancini Mario, Riccardi Gabriele, Zanchetti Alberto
Department of Clinical and Experimental Medicine, Federico II University of Naples, Italy.
Clin Endocrinol (Oxf). 2003 Mar;58(3):316-22. doi: 10.1046/j.1365-2265.2003.01715.x.
There is substantial but not conclusive evidence that insulin resistance is related to left ventricular mass (LVM) in hypertensive individuals. To what extent this association is mediated by the relationship between plasma insulin and body size and build is still debated, and is poorly explored in nonhypertensive people.
To explore the relationship between insulin or insulin resistance and LVM in a population-based sample of nonhypertensive participants of the Gubbio Study.
Echocardiographic LVM was determined in 91 nondiabetic, nonhypertensive individuals aged 45-54 years, participating in a population-based screening. LVM normalized for height2.7 was used in the analyses; LV hypertrophy was defined as a value of > or = 50 g/m2.7 in men or > or = 47 g/m2.7 in women. Fasting plasma insulin and glucose were measured and the Homeostasis Model Assessment (HOMA) index was used as a measure of insulin resistance.
LVM was positively and significantly correlated with body mass index (BMI) (P < 0.01), waist circumference (P < 0.01) and HOMA index (P < 0.05), whereas correlations with plasma glucose and triglycerides did not reach statistical significance (P = 0.07 for both); all correlations were offset after adjusting for BMI. Fasting plasma insulin and HOMA index were not significantly different in subjects with or without LV hypertrophy (70.8 +/- 27.8 vs. 77.7 +/- 29.6 pmol/l and 2.2 +/- 1.0 vs. 2.6 +/- 1.4, respectively). Bivariate analysis performed stratifying participants above or below the 75th percentile of the sex-specific distribution for BMI (29.1 and 29.4 kg/m2 for males and females, respectively) and plasma insulin (84 pmol/l for either gender), did not result in appreciable differences in LVM due to insulin levels. Similar results were obtained replacing the HOMA index for insulin in the analysis.
In nonhypertensive individuals left ventricular mass is not associated with plasma insulin independently of body mass index.
有大量但并非结论性的证据表明，胰岛素抵抗与高血压患者的左心室质量（LVM）有关。这种关联在多大程度上是由血浆胰岛素与体型和体格之间的关系介导的，仍存在争议，且在非高血压人群中研究较少。
在基于古比奥研究的非高血压参与者人群样本中，探讨胰岛素或胰岛素抵抗与LVM之间的关系。
对91名年龄在45 - 54岁的非糖尿病、非高血压个体进行超声心动图LVM测定，这些个体参与了一项基于人群的筛查。分析中使用身高2.7标准化的LVM；左心室肥厚定义为男性≥50 g/m2.7或女性≥47 g/m2.7。测量空腹血浆胰岛素和葡萄糖，并使用稳态模型评估（HOMA）指数作为胰岛素抵抗的指标。
LVM与体重指数（BMI）（P < 0.01）、腰围（P < 0.01）和HOMA指数（P < 0.05）呈正相关且具有统计学意义，而与血浆葡萄糖和甘油三酯的相关性未达到统计学意义（两者P = 0.07）；调整BMI后，所有相关性均消失。有或无左心室肥厚的受试者空腹血浆胰岛素和HOMA指数无显著差异（分别为70.8±27.8对77.7±29.6 pmol/l和2.2±1.0对2.6±1.4）。根据BMI性别特异性分布的第75百分位数（男性和女性分别为29.1和29.4 kg/m2）和血浆胰岛素（两性均为84 pmol/l）对参与者进行分层的双变量分析显示，由于胰岛素水平，LVM没有明显差异。在分析中用HOMA指数替代胰岛素得到了类似结果。
在非高血压个体中，独立于体重指数，左心室质量与血浆胰岛素无关。
