非糖尿病老年男性中胰岛素抵抗与步态速度呈负相关：来自美国国家健康和营养调查（NHANES）1999-2002 年的结果。
Inverse association between insulin resistance and gait speed in nondiabetic older men: results from the U.S. National Health and Nutrition Examination Survey (NHANES) 1999-2002.
机构信息
Department of Emergency Medicine, Chang-Gung Memorial Hospital-Kaohsiung Medical Center, No.123, Dapi Rd., NiaosongTownship, Kaohsiung County 833, Taiwan.
出版信息
BMC Geriatr. 2009 Nov 19;9:49. doi: 10.1186/1471-2318-9-49.
BACKGROUND
Recent studies have revealed the associations between insulin resistance (IR) and geriatric conditions such as frailty and cognitive impairment. However, little is known about the relation of IR to physical impairment and limitation in the aging process, eg. slow gait speed and poor muscle strength. The aim of this study is to determine the effect of IR in performance-based physical function, specifically gait speed and leg strength, among nondiabetic older adults.
METHODS
Cross-sectional data were from the population-based National Health and Nutrition Examination Survey (1999-2002). A total of 1168 nondiabetic adults (> or = 50 years) with nonmissing values in fasting measures of insulin and glucose, habitual gait speed (HGS), and leg strength were analyzed. IR was assessed by homeostasis model assessment (HOMA-IR), whereas HGS and peak leg strength by the 20-foot timed walk test and an isokinetic dynamometer, respectively. We used multiple linear regression to examine the association between IR and performance-based physical function.
RESULTS
IR was inversely associated with gait speed among the men. After adjusting demographics, body mass index, alcohol consumption, smoking status, chronic co-morbidities, and markers of nutrition and cardiovascular risk, each increment of 1 standard deviation in the HOMA-IR level was associated with a 0.04 m/sec decrease (p = 0.003) in the HGS in men. We did not find such association among the women. The IR-HGS association was not changed after further adjustment of leg strength. Last, HOMA-IR was not demonstrated in association with peak leg strength.
CONCLUSION
IR is inversely associated with HGS among older men without diabetes. The results suggest that IR, an important indicator of gait function among men, could be further investigated as an intervenable target to prevent walking limitation.
背景
最近的研究揭示了胰岛素抵抗（IR）与衰弱和认知障碍等老年病的关联。然而，对于 IR 与衰老过程中的身体损伤和功能限制的关系，例如缓慢的步态速度和较差的肌肉力量，我们知之甚少。本研究旨在确定 IR 对非糖尿病老年人群的基于表现的身体功能（特别是步态速度和腿部力量）的影响。
方法
横断面数据来自基于人群的全国健康和营养检查调查（1999-2002 年）。共分析了 1168 名非糖尿病成年人（≥50 岁），他们的空腹胰岛素和葡萄糖测量值、习惯性步态速度（HGS）和腿部力量均无缺失值。通过稳态模型评估（HOMA-IR）评估 IR，通过 20 英尺定时步行测试和等速测力计分别评估 HGS 和峰值腿部力量。我们使用多元线性回归来检验 IR 与基于表现的身体功能之间的关联。
结果
IR 与男性的步态速度呈负相关。在调整人口统计学、体重指数、饮酒、吸烟状况、慢性合并症以及营养和心血管风险标志物后，HOMA-IR 水平每增加 1 个标准差，男性的 HGS 会降低 0.04 米/秒（p=0.003）。我们在女性中未发现这种关联。进一步调整腿部力量后，IR-HGS 关联没有改变。最后，HOMA-IR 与峰值腿部力量无关。
结论
IR 与无糖尿病的老年男性的 HGS 呈负相关。结果表明，IR 是男性步态功能的一个重要指标，可进一步作为干预目标进行研究，以预防行走受限。
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