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韩国老年人胰岛素抵抗与血液学参数的关系——首尔西南部(SWS)研究

Relation between insulin resistance and hematological parameters in elderly Koreans-Southwest Seoul (SWS) Study.

作者信息

Choi K M, Lee J, Kim Y H, Kim K B, Kim D L, Kim S G, Shin D H, Kim N H, Park I B, Choi D S, Baik S H

机构信息

Department of Internal Medicine, College of Medicine, Korea University Guro Hospital, 80 Guro-Dong, Guro-Gu, Seoul 152-050, South Korea.

出版信息

Diabetes Res Clin Pract. 2003 Jun;60(3):205-12. doi: 10.1016/s0168-8227(03)00059-7.

Abstract

In this study, we investigated the relation between insulin resistance and hematological parameters in elderly Koreans. This study included 1314 non-diabetic subjects over the age of 60, selected from a cross-sectional study, which was conducted in 1999 in Seoul, Korea. We measured fasting and post-load 2 h plasma glucose, insulin levels, lipid profiles, anthropometric measures, and hematological parameters. The degree of insulin resistance was assessed using the homeostasis model assessment (HOMA). We found a correlation between insulin resistance and hemoglobin concentrations in non-smoking men (r=0.20, P=0.0186). In non-smoking women, insulin resistance correlated with hemoglobin (r=0.10, P=0.0017) and with white blood cell (WBC) count (r=0.15, P=0.001). Hemoglobin concentrations and WBC counts were also associated with other components of the insulin resistance syndrome such as body mass index, blood pressure, lipid profiles and fasting plasma insulin levels (surrogate for insulin resistance). Furthermore, the group in the upper quartile for insulin resistance showed higher hemoglobin concentrations and WBC counts than the lower quartile, independent of smoking status and serum iron concentrations. Using HOMA-IR as a dependent variable in a multiple regression analysis, age, body mass index (BMI), waist-to-hip ratio (WHR), systolic blood pressure, HDL cholesterol, triglyceride, WBC count, hemoglobin, hematocrit and serum TIBC were significant. Our results provide support for a relation between insulin resistance/hyperinsulinemia and hematological parameters such as hemoglobin concentrations and WBC counts in elderly Koreans. This suggests that increased erythropoiesis and subclinical inflammation could be part of the metabolic syndrome in elderly Koreans.

摘要

在本研究中,我们调查了韩国老年人胰岛素抵抗与血液学参数之间的关系。本研究纳入了1314名60岁以上的非糖尿病受试者,这些受试者选自1999年在韩国首尔进行的一项横断面研究。我们测量了空腹及负荷后2小时的血浆葡萄糖、胰岛素水平、血脂谱、人体测量指标和血液学参数。使用稳态模型评估(HOMA)来评估胰岛素抵抗程度。我们发现,在不吸烟男性中,胰岛素抵抗与血红蛋白浓度之间存在相关性(r = 0.20,P = 0.0186)。在不吸烟女性中,胰岛素抵抗与血红蛋白(r = 0.10,P = 0.0017)以及白细胞(WBC)计数(r = 0.15,P = 0.001)相关。血红蛋白浓度和WBC计数还与胰岛素抵抗综合征的其他组成部分相关,如体重指数、血压、血脂谱和空腹血浆胰岛素水平(胰岛素抵抗的替代指标)。此外,无论吸烟状态和血清铁浓度如何,胰岛素抵抗处于上四分位数的组比下四分位数的组具有更高的血红蛋白浓度和WBC计数。在多元回归分析中,将HOMA-IR作为因变量,年龄、体重指数(BMI)、腰臀比(WHR)、收缩压、高密度脂蛋白胆固醇、甘油三酯、WBC计数、血红蛋白、血细胞比容和血清总铁结合力均具有显著性。我们的结果支持了韩国老年人胰岛素抵抗/高胰岛素血症与血红蛋白浓度和WBC计数等血液学参数之间的关系。这表明红细胞生成增加和亚临床炎症可能是韩国老年人代谢综合征的一部分。

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