Kasayama S, Saito H, Mukai M, Koga M
Department of Molecular Medicine, Osaka University Graduate School of Medicine, Suita, Osaka, and Department of Internal Medicine, Kinki Central Hospital, Hyogo, Japan.
Diabet Med. 2005 Dec;22(12):1701-6. doi: 10.1111/j.1464-5491.2005.01718.x.
Measurement of pulse-wave velocity (PWV) is a non-invasive technique for assessing arterial stiffness. Although insulin resistance is associated with intimal-medial thickness of the carotid artery evaluated by B-mode ultrasonography, it is not known whether it is related to PWV. The aim of this study was to determine the relationship between homeostasis model assessment insulin sensitivity index (HOMA-%S) and PWV in non-diabetic subjects. We also examined the effects of oral glucose tolerance test (OGTT) 2-h glucose and plasma high-sensitivity C-reactive protein (CRP) on PWV, as these two parameters are associated with atherosclerosis.
A 75-g oral glucose tolerance test was performed in 1934 Japanese subjects who were undergoing health examinations. Of these subjects, we recruited 1541 non-diabetic subjects without chronic or acute inflammation, malignant diseases, autoimmune disorders, elevated serum creatinine levels, and abnormal hepatic function tests. Subjects who had an abnormal ankle/brachial blood pressure index of less than 0.9 were also excluded. Brachial-ankle PWV and plasma high-sensitivity CRP were measured on 1541 subjects who satisfied the admission criteria.
PWV was 12.55+/-1.61 (mean+/-sd) m/s and plasma CRP concentration was 0.4 mg/l (median, range, 0.1-5.8 mg/l) in the study subjects. By multivariate regression analysis, HOMA-%S was found to be an independent negative risk factor for PWV, while systolic blood pressure, age and triglycerides were positively associated with PWV. OGTT 2-h glucose was weakly and independently related to PWV in male subjects. Plasma CRP was not independently associated with PWV.
Insulin resistance is independently associated with PWV in non-diabetic subjects.
脉搏波速度（PWV）测量是评估动脉僵硬度的一种非侵入性技术。尽管胰岛素抵抗与通过B型超声评估的颈动脉内膜中层厚度相关，但尚不清楚它是否与PWV有关。本研究的目的是确定非糖尿病受试者中稳态模型评估胰岛素敏感性指数（HOMA-%S）与PWV之间的关系。我们还研究了口服葡萄糖耐量试验（OGTT）2小时血糖和血浆高敏C反应蛋白（CRP）对PWV的影响，因为这两个参数与动脉粥样硬化有关。
对1934名接受健康检查的日本受试者进行了75克口服葡萄糖耐量试验。在这些受试者中，我们招募了1541名无慢性或急性炎症、恶性疾病、自身免疫性疾病、血清肌酐水平升高及肝功能检查异常的非糖尿病受试者。踝臂血压指数异常低于0.9的受试者也被排除。对1541名符合入选标准的受试者测量了臂踝PWV和血浆高敏CRP。
研究对象的PWV为12.55±1.61（均值±标准差）m/s，血浆CRP浓度为0.4mg/l（中位数，范围0.1 - 5.8mg/l）。通过多因素回归分析，发现HOMA-%S是PWV的独立负性危险因素，而收缩压、年龄和甘油三酯与PWV呈正相关。OGTT 2小时血糖在男性受试者中与PWV呈弱独立相关。血浆CRP与PWV无独立相关性。
在非糖尿病受试者中，胰岛素抵抗与PWV独立相关。
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