Pradhan Aruna D, Cook Nancy R, Buring Julie E, Manson JoAnn E, Ridker Paul M
Center for Cardiovascular Disease Prevention, Brigham and Women's Hospital, 900 Commonwealth Ave E, Boston, Mass 02215-1204, USA.
Arterioscler Thromb Vasc Biol. 2003 Apr 1;23(4):650-5. doi: 10.1161/01.ATV.0000065636.15310.9C. Epub 2003 Mar 6.
Insulin resistance is associated with chronic subclinical inflammation, and both conditions are linked with increased risk for type 2 diabetes mellitus and atherothrombotic cardiovascular disease.
In a cross-sectional study conducted among participants in the Women's Health Study, an ongoing US primary prevention trial of cardiovascular disease and cancer, we evaluated the correlates of elevated fasting insulin, a marker of insulin resistance, among 349 healthy, nondiabetic women who remained free from clinically diagnosed type 2 diabetes mellitus during a 4-year period from biomarker assessment. Fasting insulin was strongly associated with body mass index (BMI) (r=0.53, P<0.001), C-reactive protein (CRP) (r=0.38, P<0.001), and interleukin-6 (r=0.33, P<0.001). Physical activity level, alcohol consumption, and use of hormone replacement therapy were also related to fasting insulin. However, in multivariable linear regression analysis, BMI and CRP were the only independent correlates of log-normalized fasting insulin. Overall, the final model explained 32% of the variance in log insulin level. In multivariable logistic regression, the fully adjusted odds ratio (OR) for elevated fasting insulin (>or=51.6 pmol/L) increased with tertile of BMI, CRP, and IL-6, such that the ORs in the highest versus lowest tertile of each parameter were 9.0 (95% confidence interval [CI], 4.4 to 18.7), 4.4 (95% CI, 1.9 to 10.1), and 2.0 (95% CI, 0.9 to 4.2), respectively. Furthermore, increasing levels of CRP were associated with a stepwise gradient in odds for elevated fasting insulin among both lean and overweight women.
CRP is independently associated with fasting hyperinsulinemia in nondiabetic women. These data provide additional support for previously reported associations between subclinical inflammation and the risk of type 2 diabetes and cardiovascular disease.
胰岛素抵抗与慢性亚临床炎症相关，且这两种情况均与2型糖尿病和动脉粥样硬化性心血管疾病风险增加有关。
在一项针对女性健康研究参与者开展的横断面研究中，该研究是美国一项正在进行的心血管疾病和癌症一级预防试验，我们评估了349名健康非糖尿病女性中空腹胰岛素升高（胰岛素抵抗的一个指标）的相关因素，这些女性在从生物标志物评估开始的4年期间未出现临床诊断的2型糖尿病。空腹胰岛素与体重指数（BMI）（r = 0.53，P < 0.001）、C反应蛋白（CRP）（r = 0.38，P < 0.001）和白细胞介素-6（r = 0.33，P < 0.001）密切相关。身体活动水平、饮酒情况和激素替代疗法的使用也与空腹胰岛素有关。然而，在多变量线性回归分析中，BMI和CRP是对数正态化空腹胰岛素的唯一独立相关因素。总体而言，最终模型解释了胰岛素水平对数方差的32%。在多变量逻辑回归中，空腹胰岛素升高（≥51.6 pmol/L）的完全调整优势比（OR）随着BMI、CRP和IL-6的三分位数增加，使得每个参数最高三分位数与最低三分位数的OR分别为9.0（95%置信区间[CI]，4.4至18.7）、4.4（95%CI，1.9至10.1）和2.0（95%CI，0.9至4.2）。此外，CRP水平升高与瘦女性和超重女性空腹胰岛素升高的优势比呈逐步梯度相关。
CRP与非糖尿病女性空腹高胰岛素血症独立相关。这些数据为先前报道的亚临床炎症与2型糖尿病和心血管疾病风险之间的关联提供了额外支持。
