Yamada Y, Noborisaka Y, Ishizaki M, Tsuritani I, Honda R, Yamada S
Department of Hygiene, Kanazawa Medical University, Uchinada, Ishikawa, Japan.
J Hum Hypertens. 2004 May;18(5):343-50. doi: 10.1038/sj.jhh.1001678.
A total of 1595 middle-aged healthy men consuming alcohol up to 120 ml per day and 538 without alcohol consumption were recruited from an occupational population, and their insulin resistance (IR) and beta-cell function (BC) were measured using the homeostasis model assessment (HOMA-IR and HOMA-BC), and the associations with alcohol consumption, blood pressure (BP), and serum gamma-glutamyltransferase (GGT) levels were analysed cross-sectionally. Both HOMA-IR and HOMA-BC were decreased with increasing alcohol consumption, but HOMA-BC corresponding to a level of HOMA-IR was 4-10 and 8-20% lower in drinkers consuming less than 60 ml of alcohol per day and those consuming more, respectively, than in nondrinkers, suggesting an altered fasting serum insulin-glucose relationship in alcohol consumers. Although BP was higher and HOMA-IR was lower in alcohol consumers than in nonconsumers, BP was higher at higher HOMA-IR irrespective of alcohol consumption. Elevations of serum GGT were positively associated with BP and HOMA-IR in both alcohol consumers and nonconsumers. Multiple regression analyses in the subjects showed that elevated serum GGT was an independent contributor to HOMA-IR elevations, and both serum GGT and HOMA-IR were significantly related to BP elevations after adjusting for alcohol consumption, age, body mass index, cigarette consumption, and physical activity at leisure. Although cross-sectional observations do not provide evidence of causal association, the results suggest that elevated serum GGT in alcohol consumers relates to elevations of IR and that the elevated insulin resistance relates, at least partly, to BP elevations in alcohol consumers.
从职业人群中招募了1595名每天饮酒量达120毫升的中年健康男性和538名不饮酒者,采用稳态模型评估法(HOMA-IR和HOMA-BC)测量他们的胰岛素抵抗(IR)和β细胞功能(BC),并对饮酒量、血压(BP)和血清γ-谷氨酰转移酶(GGT)水平之间的关联进行横断面分析。HOMA-IR和HOMA-BC均随饮酒量增加而降低,但每天饮酒量少于60毫升的饮酒者和饮酒量更多的饮酒者,对应相同HOMA-IR水平时,其HOMA-BC分别比不饮酒者低4-10%和8-20%,这表明饮酒者空腹血清胰岛素与葡萄糖的关系发生了改变。尽管饮酒者的血压较高且HOMA-IR较低,但无论饮酒与否,HOMA-IR越高血压越高。血清GGT升高在饮酒者和不饮酒者中均与血压和HOMA-IR呈正相关。对这些受试者进行的多元回归分析表明,血清GGT升高是HOMA-IR升高的独立影响因素,在调整饮酒量、年龄、体重指数、吸烟量和休闲时的身体活动后,血清GGT和HOMA-IR均与血压升高显著相关。虽然横断面观察不能提供因果关联的证据,但结果表明饮酒者血清GGT升高与IR升高有关,且胰岛素抵抗升高至少部分与饮酒者的血压升高有关。