Lee Ji-Won, Lee Duk-Chul, Im Jee-Aee, Shim Jae-Yong, Kim Sang-Man, Lee Hye-Ree
Department of Family Medicine, Yonsei University, College of Medicine, Yongdong Severance Hospital, Seoul, Korea.
Hypertens Res. 2007 Jan;30(1):5-11. doi: 10.1291/hypres.30.5.
To determine the relationship between insulin resistance (IR) and arterial stiffness independent of obesity in male adolescents, we evaluated body fat, lipid parameters, indices of IR (fasting insulin, and the homeostasis model assessment of insulin resistance [HOMA-IR]), indices of insulin sensitivity (IS) (fasting glucose/fasting insulin [GF/IF], and the quantitative insulin sensitivity check index [QUICKI]), and lifestyle parameters in 256 male adolescents. We divided the study group into the following four subgroups based on the median value of HOMA-IR and obesity: non-obese with IS, non-obese with IR, obese with IS, and obese with IR. In order to estimate arterial stiffness, we measured brachial ankle pulse wave velocity (baPWV). Despite having a high body mass index (BMI), obese-IS adolescents showed a significantly lower fasting insulin and baPWV, but had higher IS indices than non-obese-IR adolescents. After an adjustment for age, BMI, waist-to-hip ratio, mean blood pressure, heart rate, total cholesterol level, triglyceride, alanine aminotransferase (ALT) level, physical activity, and television and computer usage, multiple regression models showed that baPWV was independently correlated with IR and IS indices. In conclusion, our results demonstrate an association between IR and baPWV independent of weight, suggesting that IR is a risk factor for the development of early atherosclerosis. Interventions that decrease IR in addition to weight reduction may be necessary to alter the early development of cardiovascular risk.
为了确定男性青少年中独立于肥胖的胰岛素抵抗(IR)与动脉僵硬度之间的关系,我们评估了256名男性青少年的体脂、血脂参数、IR指标(空腹胰岛素以及胰岛素抵抗稳态模型评估[HOMA-IR])、胰岛素敏感性(IS)指标(空腹血糖/空腹胰岛素[GF/IF]以及定量胰岛素敏感性检查指数[QUICKI])和生活方式参数。我们根据HOMA-IR的中位数和肥胖情况将研究组分为以下四个亚组:具有IS的非肥胖者、具有IR的非肥胖者、具有IS的肥胖者和具有IR的肥胖者。为了评估动脉僵硬度,我们测量了肱踝脉搏波速度(baPWV)。尽管肥胖-IS青少年的体重指数(BMI)较高,但他们的空腹胰岛素和baPWV显著较低,但IS指标高于非肥胖-IR青少年。在对年龄、BMI、腰臀比、平均血压、心率、总胆固醇水平、甘油三酯、丙氨酸转氨酶(ALT)水平、身体活动以及电视和电脑使用情况进行调整后,多元回归模型显示baPWV与IR和IS指标独立相关。总之,我们的结果表明IR与baPWV之间存在独立于体重的关联,提示IR是早期动脉粥样硬化发生的一个危险因素。除减轻体重外,降低IR的干预措施可能对于改变心血管风险的早期发展是必要的。