炎症标志物对老年人胰岛素抵抗及胰岛素抵抗综合征的多样影响。
Diverse effect of inflammatory markers on insulin resistance and insulin-resistance syndrome in the elderly.
作者信息
Abbatecola Angela M, Ferrucci Luigi, Grella Rodolfo, Bandinelli Stefania, Bonafè Massimiliano, Barbieri Michelangela, Corsi Anna M, Lauretani Fulvio, Franceschi Claudio, Paolisso Giuseppe
机构信息
Department of Geriatric Medicine and Metabolic Diseases, II University of Naples, Naples, Italy.
出版信息
J Am Geriatr Soc. 2004 Mar;52(3):399-404. doi: 10.1111/j.1532-5415.2004.52112.x.
OBJECTIVES
To evaluate the potential association between different inflammatory markers and insulin resistance (IR), as well as insulin-resistance syndrome (IRS) in a large, population-based study of older, nondiabetic persons.
DESIGN
Cross-sectional study.
SETTING
Outpatient clinic in Greve in Chianti and Bagno a Ripoli (Italy).
PARTICIPANTS
One thousand one hundred forty-six nondiabetic subjects ranging in age from 22 to 104.
MEASUREMENTS
Anthropometric measurements; plasma fasting levels of glucose, insulin, and cholesterol (total, high-density lipoprotein, low-density lipoprotein); homeostasis model assessment to estimate degree of insulin resistance; tumor necrosis factor alpha (TNF-alpha), interleukin 6 (IL-6), soluble IL-6 receptor (sIL-6R), interleukin receptor antagonist (IL-1ra), and C-reactive protein (CRP) plasma concentrations; diastolic, systolic, and mean arterial blood pressure; and echo-color-Doppler duplex scanning examination of carotid arteries.
RESULTS
Insulin resistance correlated with age (r=0.102; P<.001) and plasma levels of TNF-alpha (r=0.082; P=.007), IL-1ra (r=0.147; P<.001), IL-6 (r=0.133; P<.001), sIL-6R (r=-0.156; P<.001), and CRP (r=0.83; P<.001). Subjects in the upper tertile of IR degree were older and had higher serum levels of TNF-alpha, IL-1ra, and IL-6 and lower levels of sIL-6R than subjects in the lowest tertile. Independent of age, sex, body mass index, waist-to-hip ratio, triglycerides, drug intake, diastolic blood pressure, smoking habit, and carotid atherosclerotic plaques, higher IL-6 (t=2.987; P=.003) serum concentrations were associated with higher IR, whereas sIL-6R levels (t=-5.651; P<.001) were associated with lower IR. Furthermore, IL-1ra concentrations (t=2.448; P=.015) were associated with IRS, and higher sIL-6R plasma levels continued to correlate negatively with IRS.
CONCLUSION
Different inflammatory markers are associated with a diverse effect on IR and IRS in elderly nondiabetic subjects.
目的
在一项针对老年非糖尿病患者的大型人群研究中，评估不同炎症标志物与胰岛素抵抗（IR）以及胰岛素抵抗综合征（IRS）之间的潜在关联。
设计
横断面研究。
地点
意大利基安蒂地区格雷韦和巴尼奥阿里波利的门诊诊所。
参与者
1146名年龄在22岁至104岁之间的非糖尿病受试者。
测量指标
人体测量指标；空腹血糖、胰岛素和胆固醇（总胆固醇、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇）的血浆水平；采用稳态模型评估来估计胰岛素抵抗程度；肿瘤坏死因子α（TNF-α）、白细胞介素6（IL-6）、可溶性IL-6受体（sIL-6R）、白细胞介素受体拮抗剂（IL-1ra）和C反应蛋白（CRP）的血浆浓度；舒张压、收缩压和平均动脉压；以及颈动脉的超声彩色多普勒双功扫描检查。
结果
胰岛素抵抗与年龄（r = 0.10²；P <.001）、TNF-α血浆水平（r = 0.082；P =.007）、IL-1ra（r = 0.147；P <.001）、IL-6（r = 0.133；P <.001）、sIL-6R（r = -0.156；P <.001）和CRP（r = 0.83；P <.001）相关。IR程度处于最高三分位数的受试者比最低三分位数的受试者年龄更大，TNF-α、IL-1ra和IL-6的血清水平更高，而sIL-6R水平更低。独立于年龄、性别、体重指数、腰臀比、甘油三酯、药物摄入、舒张压、吸烟习惯和颈动脉粥样硬化斑块，较高水平IL-6（t = 2.987；P =.003）的血清浓度与较高的IR相关，而sIL-6R水平（t = -5.651；P <.001）与较低的IR相关。此外，IL-1ra浓度（t = 2.448；P =.015）与IRS相关，较高的sIL-6R血浆水平继续与IRS呈负相关。
结论
不同的炎症标志物对老年非糖尿病受试者的IR和IRS有不同的影响。
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