Hills S A, Balkau B, Coppack S W, Dekker J M, Mari A, Natali A, Walker M, Ferrannini E
EGIR-RISC Coordinating Office, Department of Internal Medicine, University of Pisa School of Medicine, Via Roma, 67, 56100, Pisa, Italy.
INSERM U 258, Villejuif, France.
Diabetologia. 2004 Mar;47(3):566-570. doi: 10.1007/s00125-004-1335-5. Epub 2004 Feb 14.
AIMS/HYPOTHESES: Insulin resistance is thought to be a key predictor for the development of Type 2 diabetes mellitus and cardiovascular disease (CVD), a leading cause of morbidity and premature mortality in Europe. Insulin resistance is influenced by both genetic and lifestyle factors (e.g. obesity and physical inactivity). The RISC (Relationship between Insulin Sensitivity and Cardiovascular disease) Study is using the infrastructure of an extended European collaborative research group to study insulin resistance and CVD risk in 1500 healthy people aged 30 to 60 years from 20 centres in 13 countries.
Baseline measurements of glucose tolerance and insulin sensitivity are made by the oral glucose tolerance test and the euglycaemic insulin clamp, respectively; carotid artery intima-medial thickness (by ultrasound), ankle/brachial pressure index and electrocardiography will enable evaluation of subclinical CVD at baseline and at follow-up. Classic CVD risk factors, as well as socioeconomic and lifestyle factors will be recorded at baseline; samples for measurement of biochemical and genetic markers will be collected and stored for future analyses. Investigations will be repeated after 3 and 10 years to evaluate the relationship between insulin resistance and the development of atherosclerosis as measured by carotid artery intima-media thickness. Development of Type 2 diabetes, dyslipidaemia, obesity, hypertension and cardiovascular events are additional endpoints.
This study will evaluate the importance of insulin resistance in the development of CVD and diabetes, and has implications for the development of prevention and treatment strategies.
目的/假设：胰岛素抵抗被认为是2型糖尿病和心血管疾病（CVD）发生的关键预测因素，而心血管疾病是欧洲发病和过早死亡的主要原因。胰岛素抵抗受遗传和生活方式因素（如肥胖和缺乏身体活动）的影响。RISC（胰岛素敏感性与心血管疾病的关系）研究正在利用一个扩展的欧洲合作研究小组的基础设施，对来自13个国家20个中心的1500名30至60岁的健康人进行胰岛素抵抗和心血管疾病风险的研究。
分别通过口服葡萄糖耐量试验和正常血糖胰岛素钳夹试验对葡萄糖耐量和胰岛素敏感性进行基线测量；颈动脉内膜中层厚度（通过超声测量）、踝/臂压力指数和心电图将用于评估基线和随访时的亚临床心血管疾病。经典的心血管疾病危险因素以及社会经济和生活方式因素将在基线时记录；将收集用于测量生化和遗传标志物的样本并储存以备将来分析。3年和10年后将重复进行调查，以评估胰岛素抵抗与通过颈动脉内膜中层厚度测量的动脉粥样硬化发展之间的关系。2型糖尿病、血脂异常、肥胖、高血压和心血管事件的发生是额外的终点。
本研究将评估胰岛素抵抗在心血管疾病和糖尿病发生中的重要性，并对预防和治疗策略的制定具有启示意义。
