Department of Endocrinology, Fujian Provincial Hospital, Fujian Medical University, Box 4-704, Fuzhou 350001, China.
Metabolism. 2010 Dec;59(12):1823-32. doi: 10.1016/j.metabol.2010.06.009. Epub 2010 Jul 23.
The aim of this study was to evaluate the associations of body mass index (BMI) with insulin resistance and β-cell function in subjects with normal glucose tolerance. A cross-sectional study was carried out in Fujian province by multistratified sampling from July 2007 to May 2008. The sample consisted of 2931 subjects aged from 20 to 79 years. The questionnaires, physical examinations, and laboratory tests were obtained from all the participants. The homeostasis model assessment of insulin resistance (HOMA-IR) index was used to estimate insulin sensitivity, insulin secretion was assessed using the HOMA-β index, and β-cell function was quantified as the ratio of the incremental insulin to glucose responses over the first 30 minutes during the oral glucose tolerance test (ΔI30/ΔG30). Another measure was adjusted for insulin sensitivity as it modulates β-cell function ([ΔI30/ΔG30]/HOMA-IR). Associations of BMI with morbidities were estimated using multiple logistic regression analysis. Relationships of BMI to insulin resistance and β-cell function were assessed using multiple linear regression analysis and analysis of covariance. The age- and sex-adjusted prevalence of overweight and obesity was 23.04% (27.44% in men and 18.40% in women) and 2.65% (2.75% in men and 2.55% in women), respectively. After adjustment for covariables, BMI was independently associated with morbidity conditions; and there were increasing trend for odds ratios of morbidities across the BMI categories. There were independent differences for HOMA-IR, HOMA-β, and ΔI30/ΔG30 between the normal-weight, overweight, and obese groups except for (ΔI30/ΔG30)/HOMA-IR. Body mass index was significantly and independently associated with HOMA-IR, HOMA-β, and ΔI30/ΔG30 in the multiple linear regression analysis. Body mass index was an independent risk factor for hypertension, type 2 diabetes mellitus, dyslipidemia, metabolic syndrome, as well as the indexes of insulin resistance and β-cell function. It is imperative that the whole society pay more attention to the identification and intervention of overweight and obesity to prevent obesity-related diseases at the very early stage.
本研究旨在评估体重指数（BMI）与糖耐量正常人群胰岛素抵抗和β细胞功能的相关性。2007 年 7 月至 2008 年 5 月，采用多阶段分层抽样方法在福建省进行了一项横断面研究。该样本包括 2931 名年龄在 20 至 79 岁的受试者。所有参与者均接受问卷调查、体格检查和实验室检查。采用稳态模型评估胰岛素抵抗（HOMA-IR）指数来估计胰岛素敏感性，采用 HOMA-β指数评估胰岛素分泌，通过口服葡萄糖耐量试验中 30 分钟内胰岛素与血糖增量反应的比值（ΔI30/ΔG30）来量化β细胞功能。另一个指标是调整后的胰岛素敏感性，因为它调节β细胞功能（[ΔI30/ΔG30]/HOMA-IR）。采用多因素 logistic 回归分析评估 BMI 与发病率的关系。采用多元线性回归分析和协方差分析评估 BMI 与胰岛素抵抗和β细胞功能的关系。经年龄和性别调整后，超重和肥胖的患病率分别为 23.04%（男性为 27.44%，女性为 18.40%）和 2.65%（男性为 2.75%，女性为 2.55%）。调整协变量后，BMI 与发病情况独立相关；随着 BMI 类别增加，发病率的比值比呈上升趋势。除（ΔI30/ΔG30）/HOMA-IR 外，正常体重、超重和肥胖组之间的 HOMA-IR、HOMA-β和ΔI30/ΔG30 存在独立差异。多元线性回归分析显示，BMI 与 HOMA-IR、HOMA-β和ΔI30/ΔG30 显著且独立相关。BMI 是高血压、2 型糖尿病、血脂异常、代谢综合征以及胰岛素抵抗和β细胞功能指标的独立危险因素。全社会必须更加重视超重和肥胖的识别和干预，以便在早期阶段预防肥胖相关疾病。
