Wohlin M, Sundström J, Arnlöv J, Andrén B, Zethelius B, Lind L
Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
Atherosclerosis. 2003 Sep;170(1):181-5. doi: 10.1016/s0021-9150(03)00283-1.
Most previous studies of associations between insulin sensitivity and common carotid artery (CCA) atherosclerosis have been conducted in small samples, have not used direct measurement of insulin sensitivity, and have yielded inconclusive results. We investigated associations of CCA intima-media thickness (IMT) and diameter (CCA-D) measured by B-mode ultrasound and insulin sensitivity measured by the euglycemic hyperinsulinemic clamp test together with risk factors of the insulin resistance syndrome in a community-based sample of 493 elderly men. The clamp glucose disposal rate was an independent predictor of CCA-IMT in multivariate models adjusting for blood pressure, smoking, serum cholesterol, and body mass index (1% decrease in CCA-IMT for a 1 unit increase in glucose disposal rate, P=0.009). Glucose disposal rate was significantly related to CCA-D in univariate (r=-0.11, P=0.02) but not in multivariate models. In conclusion, this study is the first to establish impaired insulin sensitivity, measured by the euglycemic hyperinsulinemic clamp test, as an independent predictor of CCA-IMT in a population-based sample of elderly men.
以往大多数关于胰岛素敏感性与颈总动脉（CCA）动脉粥样硬化之间关联的研究都是在小样本中进行的，未采用胰岛素敏感性的直接测量方法，且结果尚无定论。我们在一个由493名老年男性组成的社区样本中，研究了通过B型超声测量的CCA内膜中层厚度（IMT）和直径（CCA-D）与通过正常血糖高胰岛素钳夹试验测量的胰岛素敏感性以及胰岛素抵抗综合征的危险因素之间的关联。在对血压、吸烟、血清胆固醇和体重指数进行校正的多变量模型中，钳夹葡萄糖处置率是CCA-IMT的独立预测因子（葡萄糖处置率每增加1个单位，CCA-IMT降低1%，P=0.009）。在单变量模型中，葡萄糖处置率与CCA-D显著相关（r=-0.11，P=0.02），但在多变量模型中并非如此。总之，本研究首次在基于人群的老年男性样本中证实，通过正常血糖高胰岛素钳夹试验测量的胰岛素敏感性受损是CCA-IMT的独立预测因子。
