Palaniappan Latha P, Kwan Andrea C, Abbasi Fahim, Lamendola Cindy, McLaughlin Tracey L, Reaven Gerald M
Stanford Prevention Research Center and Division of Cardiovascular Medicine/Department of Medicine, Stanford University Medical Center, Stanford, CA 94305, USA.
Metabolism. 2007 Jul;56(7):899-904. doi: 10.1016/j.metabol.2007.01.020.
South Asian Indians are at increased risk of coronary heart disease (CHD), possibly related to dyslipidemia characterized by high triglyceride (TG) and low high-density lipoprotein cholesterol (HDL-C) concentrations. The importance of differences in insulin resistance as compared to abdominal obesity in the development of this atherogenic lipoprotein profile is not clear, and the current cross-sectional study was initiated to examine this issue. Consequently, we defined the relationship between differences in insulin-mediated glucose uptake (IMGU), abdominal obesity, and various measures of lipoprotein metabolism known to increase CHD risk in 52 apparently healthy women of South Asian Indian ancestry. IMGU was quantified by determining the steady-state plasma glucose (SSPG) concentration during the insulin suppression test and abdominal obesity was assessed by measurement of waist circumference (WC), and the population was divided into tertiles on the basis of their SSPG results. Results indicated that although there were significant differences in SSPG, TG, and HDL-C values, there were no differences in age, blood pressure, total cholesterol, low-density lipoprotein cholesterol, body mass index, or WC between the highest and lowest tertiles. SSPG concentrations were significantly correlated with both log TG (r = 0.44, P = .001) and HDL-C (r = -0.44, P < .001) concentration, whereas TG and HDL-C concentrations were not significantly related to WC. Furthermore, the relationships between SSPG concentration and TG and HDL-C remained significant when adjusted for age and WC. Finally, a more extensive lipoprotein analysis indicated that the most insulin resistant tertile had higher TG concentrations, lower concentrations of HDL-C and HDL-C subclasses, and smaller and denser low-density lipoprotein particles than the most insulin sensitive tertile, despite the 2 groups not being different in age, BMI, or WC. These results indicate that a highly atherogenic lipoprotein profile seen in South Asian Indian women is significantly associated with insulin resistance independent of differences in WC.
南亚印度人患冠心病（CHD）的风险增加，这可能与以高甘油三酯（TG）和低高密度脂蛋白胆固醇（HDL-C）浓度为特征的血脂异常有关。与腹部肥胖相比，胰岛素抵抗差异在这种致动脉粥样硬化脂蛋白谱发展中的重要性尚不清楚，因此开展了本次横断面研究来探讨这一问题。为此，我们确定了52名南亚印度裔明显健康女性中胰岛素介导的葡萄糖摄取（IMGU）差异、腹部肥胖与已知会增加CHD风险的各种脂蛋白代谢指标之间的关系。通过在胰岛素抑制试验期间测定稳态血浆葡萄糖（SSPG）浓度来量化IMGU，并通过测量腰围（WC）来评估腹部肥胖，根据她们的SSPG结果将人群分为三个三分位数组。结果表明，尽管最高和最低三分位数组之间在SSPG、TG和HDL-C值上存在显著差异，但在年龄、血压、总胆固醇、低密度脂蛋白胆固醇、体重指数或WC方面没有差异。SSPG浓度与log TG（r = 0.44，P = 0.001）和HDL-C（r = -0.44，P < 0.001）浓度均显著相关，而TG和HDL-C浓度与WC无显著关系。此外，在调整年龄和WC后，SSPG浓度与TG和HDL-C之间的关系仍然显著。最后，更广泛的脂蛋白分析表明，尽管两组在年龄、BMI或WC方面没有差异，但胰岛素抵抗最强的三分位数组比胰岛素敏感性最高的三分位数组具有更高的TG浓度、更低的HDL-C和HDL-C亚类浓度，以及更小、更致密的低密度脂蛋白颗粒。这些结果表明，南亚印度女性中所见的高度致动脉粥样硬化脂蛋白谱与胰岛素抵抗显著相关，而与WC差异无关。
