Mayer E J, Burchfiel C M, Eckel R H, Marshall J A, Haskell W L, Hamman R F
Department of Preventive Medicine and Biometrics, Denver 80262.
Arterioscler Thromb. 1991 Jul-Aug;11(4):973-84. doi: 10.1161/01.atv.11.4.973.
It has been postulated that the positive effects of physical activity on high density lipoprotein cholesterol (HDL-C) and HDL-C subfraction 2 (HDL-C2) are mediated through insulin action because increased activity lowers insulin levels and lower insulin levels are associated with higher HDL-C. These relations were evaluated in a rural population of Hispanic and non-Hispanic white (NHW) adults in Colorado. Included were 138 men and 152 women with normal glucose tolerance confirmed by World Health Organization criteria. Total physical activity was assessed by 7-day recall interviews. No significant associations were observed among women. Among men, activity was inversely associated with fasting insulin (r = -0.17, p less than 0.05). From analysis of covariance models including the interaction term activity x ethnicity, total HDL-C was 43.4 mg/dl (95% confidence interval [CI] = 39.1, 47.7) in the low tertile of activity and 50.4 mg/dl (95% CI = 46.3, 54.5) in the high tertile for NHW men, after adjustment for fasting insulin, fasting glucose, body mass index (BMI), waist to hip ratio (WHR), and age. For Hispanic men, adjusted HDL-C was 43.4 mg/dl (95% CI = 38.6, 48.2) and 49.1 mg/dl (95% CI = 44.0, 54.2) in the low and high tertiles, respectively. Adjusted HDL-C2 levels were 52% higher in the most compared with the least active NHW men, whereas there was no difference by activity for Hispanic men. Higher adjusted mean levels of HDL-C3 were observed for the high compared with the low activity tertile in both ethnic groups. Ethnicity-specific models showed that for NHW men, activity explained 12% (p = 0.01), fasting insulin explained 5% (p = 0.05), and BMI explained 6% (p = 0.04) of the variability in total HDL-C, after adjustment for fasting glucose, WHR, and age. These models confirmed that effects of insulin and body fat did not explain the observed associations between activity and total HDL-C and its subfractions.
据推测，体育活动对高密度脂蛋白胆固醇（HDL-C）和HDL-C亚组分2（HDL-C2）的积极作用是通过胰岛素作用介导的，因为增加活动量会降低胰岛素水平，而较低的胰岛素水平与较高的HDL-C相关。在科罗拉多州的西班牙裔和非西班牙裔白人（NHW）农村成年人群体中对这些关系进行了评估。纳入了138名男性和152名女性，他们的糖耐量正常，符合世界卫生组织标准。通过7天回忆访谈评估总体育活动量。在女性中未观察到显著关联。在男性中，活动量与空腹胰岛素呈负相关（r = -0.17，p < 0.05）。在包括活动量×种族交互项的协方差模型分析中，在调整了空腹胰岛素、空腹血糖、体重指数（BMI）、腰臀比（WHR）和年龄后，NHW男性活动量低三分位数组的总HDL-C为43.4mg/dl（95%置信区间[CI] = 39.1, 47.7），活动量高三分位数组为50.4mg/dl（95%CI = 46.3, 54.5）。对于西班牙裔男性，低三分位数组和高三分位数组调整后的HDL-C分别为43.4mg/dl（95%CI = 38.6, 48.2）和49.1mg/dl（95%CI = 44.0, 54.2）。与活动量最少的NHW男性相比，活动量最多的男性调整后的HDL-C2水平高52%，而西班牙裔男性的HDL-C2水平在活动量方面没有差异。在两个种族群体中，活动量高三分位数组的HDL-C3调整后平均水平均高于低三分位数组。种族特异性模型显示，对于NHW男性，在调整了空腹血糖、WHR和年龄后，活动量解释了总HDL-C变异性的12%（p = 0.01），空腹胰岛素解释了5%（p = 0.05），BMI解释了6%（p = 0.04）。这些模型证实，胰岛素和体脂的作用并不能解释观察到的活动量与总HDL-C及其亚组分之间的关联。
