在血糖正常、血压正常的绝经后女性中，胰岛素抵抗独立影响动脉僵硬度。
Insulin resistance independently influences arterial stiffness in normoglycemic normotensive postmenopausal women.
机构信息
Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
出版信息
Menopause. 2010 Jul;17(4):779-84. doi: 10.1097/gme.0b013e3181cd3d60.
OBJECTIVE
Cardiovascular disease risk increases after menopause, which may be related to insulin resistance, and arterial stiffness is a significant predictor of atherosclerosis. We investigated the relationships among insulin resistance, adiponectin, and arterial stiffness in normoglycemic normotensive postmenopausal women.
METHODS
From 9,555 participants who had routine health checkups, 455 normoglycemic normotensive postmenopausal women were enrolled. Serum concentrations of glucose, total cholesterol, triglyceride (TG), and high-density lipoprotein cholesterol (HDL-C) and adiponectin were measured. Insulin resistance was estimated by the insulin resistance index of homeostasis model assessment (HOMA-IR). Pulse wave velocity (PWV) was evaluated to assess arterial stiffness.
RESULTS
The women were stratified into three groups according to their HOMA-IR values, and comparisons were made among the three groups. There were significant differences in metabolic parameters between the groups. The mean age, body mass index, waist circumference, fasting plasma glucose, TG, systolic blood pressure (SBP), diastolic blood pressure (DBP), aortic PWV, and peripheral PWV increased sequentially with the degree of insulin resistance. Meanwhile, HDL-C and adiponectin levels decreased with the worsening of insulin resistance. Age, body mass index, fasting plasma glucose, TG, insulin, SBP, HOMA-IR, aortic PWV, and peripheral PWV were significantly higher in women with central obesity, and HDL-C and adiponectin were significantly lower in women with central obesity. Aortic PWV and peripheral PWV were significantly correlated with age, waist circumference, total cholesterol, SBP, DBP, insulin, and HOMA-IR, but adiponectin was not associated with PWV. The results of multiple regression analysis indicated that SBP, DBP, and insulin resistance were independently correlated with PWV.
CONCLUSIONS
Insulin resistance was independently associated with PWV in normoglycemic normotensive postmenopausal women.
目的
绝经后心血管疾病风险增加，这可能与胰岛素抵抗有关，而动脉僵硬度是动脉粥样硬化的重要预测指标。我们研究了血糖正常、血压正常的绝经后妇女中胰岛素抵抗、脂联素和动脉僵硬度之间的关系。
方法
从进行常规健康检查的 9555 名参与者中，纳入了 455 名血糖正常、血压正常的绝经后妇女。测量了血清葡萄糖、总胆固醇、甘油三酯 (TG)、高密度脂蛋白胆固醇 (HDL-C) 和脂联素的浓度。通过稳态模型评估的胰岛素抵抗指数 (HOMA-IR) 来估计胰岛素抵抗。评估脉搏波速度 (PWV) 以评估动脉僵硬度。
结果
根据 HOMA-IR 值将女性分为三组，并对三组进行比较。组间代谢参数存在显著差异。平均年龄、体重指数、腰围、空腹血糖、TG、收缩压 (SBP)、舒张压 (DBP)、主动脉 PWV 和外周 PWV 随胰岛素抵抗程度依次增加。同时，HDL-C 和脂联素水平随胰岛素抵抗的恶化而降低。中心性肥胖女性的年龄、体重指数、空腹血糖、TG、胰岛素、SBP、HOMA-IR、主动脉 PWV 和外周 PWV 显著升高，HDL-C 和脂联素显著降低。主动脉 PWV 和外周 PWV 与年龄、腰围、总胆固醇、SBP、DBP、胰岛素和 HOMA-IR 显著相关，但脂联素与 PWV 无关。多元回归分析结果表明，SBP、DBP 和胰岛素抵抗与 PWV 独立相关。
结论
血糖正常、血压正常的绝经后妇女中，胰岛素抵抗与 PWV 独立相关。
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