Stein Elizabeth, Kushner Harvey, Gidding Samuel, Falkner Bonita
Department of Medicine, Thomas Jefferson University, Philadelphia, PA 19107, USA.
Metabolism. 2007 Jul;56(7):954-60. doi: 10.1016/j.metabol.2007.02.008.
Despite higher rates of cardiovascular disease, African Americans have a more favorable lipid profile. The purpose of the study was to examine the association between plasma lipid concentrations and insulin resistance in African Americans and to determine if insulin resistance is present at a lower triglyceride (TG) threshold than is used for metabolic syndrome criteria. Data were examined on 185 nondiabetic African American men (n = 61) and women (n = 124), mean age, 39.8 years. Measurements included blood pressure, anthropometrics, oral glucose tolerance test, and insulin sensitivity (M) by insulin clamp. The relationship between lipids and insulin sensitivity was analyzed by correlation analysis and by comparing TG levels among tertiles of M. Despite relatively low mean (+/- SD) TG level (87.8 +/- 55.2 mg/dL), there were statistically significant correlations of M with TG (r = -0.23, P < .002), high-density lipoprotein cholesterol (HDL-C; r = 0.19, P < .01), and TG/HDL-C ratio (r = -0.23, P < .002). The correlations were strongest in men. Subjects with TG in an intermediate range (110-149 mg/dL) had insulin resistance equivalent to that of the high-TG group (>/=150 mg/dL). In African Americans, TG levels below the current metabolic syndrome threshold criterion are associated with insulin resistance.
尽管心血管疾病发病率较高,但非裔美国人的血脂状况更为有利。本研究的目的是检验非裔美国人血浆脂质浓度与胰岛素抵抗之间的关联,并确定胰岛素抵抗是否在低于代谢综合征标准所使用的甘油三酯(TG)阈值时就已存在。对185名非糖尿病非裔美国男性(n = 61)和女性(n = 124)的数据进行了检查,平均年龄为39.8岁。测量指标包括血压、人体测量学指标、口服葡萄糖耐量试验以及通过胰岛素钳夹法测定的胰岛素敏感性(M)。通过相关性分析以及比较M三分位数之间的TG水平,分析了脂质与胰岛素敏感性之间的关系。尽管平均(±标准差)TG水平相对较低(87.8±55.2mg/dL),但M与TG(r = -0.23,P <.002)、高密度脂蛋白胆固醇(HDL-C;r = 0.19,P <.01)以及TG/HDL-C比值(r = -0.23,P <.002)之间存在统计学上的显著相关性。这些相关性在男性中最为明显。TG处于中间范围(110 - 149mg/dL)的受试者的胰岛素抵抗与高TG组(≥150mg/dL)相当。在非裔美国人中,低于当前代谢综合征阈值标准的TG水平与胰岛素抵抗相关。