Jia En-Zhi, Yang Zhi-Jian, Yuan Biao, Zang Xiao-Ling, Wang Rong-Hu, Zhu Tie-Bing, Wang Lian-Sheng, Chen B O, Cao Ke-Jiang, Huang Jun, Ma Wen-Zhu
Department of Cardiovascular Medicine, First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu Province, China.
Clin Cardiol. 2006 Jan;29(1):25-30. doi: 10.1002/clc.4960290107.
Reports about the relationships between specific insulin concentration and coronary heart disease risk are controversial.
The objective of this study was to examine the association between insulin level and the severity of coronary atherosclerosis.
The study population consisted of 507 consecutive patients (376 men and 131 women) who underwent coronary angiography for suspected or known coronary atherosclerosis. The patients' habits of smoking and drinking were investigated, and anthropometric measurements including body mass index, systolic and diastolic blood pressures, as well as plasma measurements including lipids and blood glucose were taken. The true insulin level was measured using a highly sensitive two-site sandwich ELISA. The severity of coronary atherosclerosis was defined by the Gensini score system. The statistical methods including Kruskal-Wallis test, chi-square analysis, Spearman correlation analysis, and multivariate stepwise linear regression analysis were employed to explore the relationship between specific insulin level and coronary atherosclerosis.
When the Gensini score was examined as a categorical variable classified by tertile values, subjects with a high Gensini score had significantly higher values of fasting plasma specific insulin level (p = 0.022). The Spearman correlation analysis suggest that the Gensini score correlated significantly with true insulin (mIU/l) (r = 0.095, p = 0.033). However, the results from the multivariate stepwise linear regression analysis show that the association between specific insulin level and severity of coronary atherosclerosis lost its significance.
The level of plasma fasting specific insulin was associated significantly with the severity of coronary atherosclerosis, as measured by Gensini score, but hyperinsulinemia showed no association with the severity of coronary atherosclerosis in multivariate analyses.
关于特定胰岛素浓度与冠心病风险之间关系的报道存在争议。
本研究的目的是检验胰岛素水平与冠状动脉粥样硬化严重程度之间的关联。
研究人群包括507例因疑似或已知冠状动脉粥样硬化而接受冠状动脉造影的连续患者（376例男性和131例女性）。调查了患者的吸烟和饮酒习惯，并进行了人体测量，包括体重指数、收缩压和舒张压，以及血浆测量，包括血脂和血糖。使用高灵敏度双位点夹心酶联免疫吸附测定法测量真实胰岛素水平。冠状动脉粥样硬化的严重程度由Gensini评分系统定义。采用Kruskal-Wallis检验、卡方分析、Spearman相关分析和多元逐步线性回归分析等统计方法探讨特定胰岛素水平与冠状动脉粥样硬化之间的关系。
当将Gensini评分作为按三分位数分类的分类变量进行检查时，Gensini评分高的受试者空腹血浆特定胰岛素水平显著更高（p = 0.022）。Spearman相关分析表明，Gensini评分与真实胰岛素（mIU/l）显著相关（r = 0.095，p = 0.033）。然而，多元逐步线性回归分析的结果表明，特定胰岛素水平与冠状动脉粥样硬化严重程度之间的关联失去了显著性。
空腹血浆特定胰岛素水平与通过Gensini评分测量的冠状动脉粥样硬化严重程度显著相关，但在多变量分析中，高胰岛素血症与冠状动脉粥样硬化严重程度无关。
