Boorsma Wiebe, Snijder Marieke B, Nijpels Giel, Guidone Caterina, Favuzzi Angela M R, Mingrone Geltrude, Kostense Piet J, Heine Robert J, Dekker Jacqueline M
EMGO Institute, VU University Medical Center, Amsterdam, The Netherlands.
Obesity (Silver Spring). 2008 Dec;16(12):2696-701. doi: 10.1038/oby.2008.433. Epub 2008 Oct 16.
To assess whether insulin sensitivity can explain the associations of leg-fat mass (LFM) and trunk-fat mass (TFM) with the cardiovascular disease (CVD) risk profile in healthy European men and women.
We studied 142 healthy men and women of a multicenter European study on insulin sensitivity, aged 30-60 years, from the centres in Hoorn, the Netherlands and Rome, Italy. Whole-body dual-energy X-ray absorptiometry (DXA) was used to determine fat and lean soft tissue mass in the trunk and legs. Fasting glucose, insulin, and lipid levels were measured. Insulin sensitivity (M/I-ratio) was measured during a euglycemic-hyperinsulinemic clamp. Associations between fat distribution and CVD risk factors were studied with linear regression analyses with adjustment for other body compartments, and subsequent adjustment for insulin sensitivity.
In men, larger LFM was significantly and independently associated with lower triglyceride levels (TGs) and higher high-density lipoprotein (HDL) cholesterol (P < 0.10) and tended to be associated also with lower low-density lipoprotein (LDL) cholesterol, and lower fasting insulin levels. In women, larger LFM was associated with favorable values of all CVD risk factors, although the associations were not statistically significant. In both sexes, larger TFM was independently and significantly associated with unfavorable values of most CVD risk factors, and most associations did not markedly change after adjustment for insulin sensitivity.
In a relatively young and healthy European population, larger LFM is associated with a lower and TFM with a higher cardiovascular and metabolic risk, which can not be explained by insulin sensitivity.
评估胰岛素敏感性是否能够解释健康欧洲男性和女性的腿部脂肪量（LFM）和躯干脂肪量（TFM）与心血管疾病（CVD）风险谱之间的关联。
我们对一项欧洲多中心胰岛素敏感性研究中的142名健康男性和女性进行了研究，他们年龄在30至60岁之间，来自荷兰霍伦和意大利罗马的研究中心。采用全身双能X线吸收法（DXA）测定躯干和腿部的脂肪及瘦软组织量。测量空腹血糖、胰岛素和血脂水平。在正常血糖-高胰岛素钳夹期间测量胰岛素敏感性（M/I比值）。通过线性回归分析研究脂肪分布与CVD危险因素之间的关联，并对其他身体部位进行调整，随后对胰岛素敏感性进行调整。
在男性中，较大的LFM与较低的甘油三酯水平（TGs）、较高的高密度脂蛋白（HDL）胆固醇显著且独立相关（P<0.10），并且也倾向于与较低的低密度脂蛋白（LDL）胆固醇和较低的空腹胰岛素水平相关。在女性中，较大的LFM与所有CVD危险因素的有利值相关，尽管这些关联无统计学意义。在男女两性中，较大的TFM与大多数CVD危险因素的不利值独立且显著相关，并且在调整胰岛素敏感性后，大多数关联没有明显变化。
在相对年轻且健康的欧洲人群中，较大的LFM与较低的心血管和代谢风险相关，而较大的TFM则与较高的心血管和代谢风险相关，这无法通过胰岛素敏感性来解释。
