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动脉僵硬度与中国人的胰岛素抵抗密切相关——一项基于人群的研究(台中社区健康研究,TCHS)。

Arterial stiffness is strongly associated with insulin resistance in Chinese--a population-based study (Taichung Community Health Study, TCHS).

机构信息

Department of Family Medicine, China Medical University Hospital, Taichung, Taiwan.

出版信息

J Atheroscler Thromb. 2011;18(2):122-30. doi: 10.5551/jat.5686. Epub 2010 Oct 30.

Abstract

AIM

Few studies have investigated the association between insulin resistance and arterial stiffness in Chinese. We aimed to investigate this relationship in a population-based study of middle-aged Chinese.

METHODS

A total of 2,188 subjects aged 40 years and older were recruited in 2004 in Taiwan. The association between arterial stiffness (measured by brachial-ankle pulse wave velocity (baPWV)) and insulin resistance (represented by homeostasis model assessment (HOMA-IR) and fasting glucose levels) was studied by multiple logistic and linear regression analyses.

RESULTS

The respective prevalence of diabetes and impaired fasting glucose (IFG) was 13.9% and 30.6% in males and 10.4% and 20.8% in females. Using multiple linear regression analyses, we found baPWV to be strongly associated with age, gender, body mass index (BMI), waist circumference (WC), systolic blood pressure (BP), diastolic BP, fasting glucose, and triglycerides. Compared to the lowest HOMA-IR tertile I and adjusting for age, BMI, WC, gender, triglycerides, systolic BP, diastolic BP, smoking, alcohol drinking, betel nut chewing, and physical activity, the odds ratios (95% confidence interval) of arterial stiffness for the higher HOMA-IR tertiles II and III were 1.15 (0.77-1.71) and 1.60 (1.05-2.46), respectively. Using a general linear model with adjustment for age, systolic BP, diastolic BP, BMI, WC, and triglycerides, baPWV was significantly lower in the diabetic group by 90.3 cm/sec in males and 100.5 cm/sec in females compared to the IFG group. When comparing the IFG group to the normal glucose group, baPWV was 28.5 cm/sec lower in males and 14.4 cm/sec lower in females.

CONCLUSIONS

Arterial stiffness is independently associated with insulin resistance in Chinese middle-aged adults. Subjects with diabetes or IFG have higher baPWV than normoglycemic subjects.

摘要

目的

在中国人群中,很少有研究调查胰岛素抵抗与动脉僵硬度之间的关系。本研究旨在对此进行人群研究。

方法

2004 年,我们在台湾共招募了 2188 名年龄在 40 岁及以上的受试者。通过多元逻辑回归和线性回归分析,研究了动脉僵硬度(肱踝脉搏波速度(baPWV))与胰岛素抵抗(用稳态模型评估(HOMA-IR)和空腹血糖水平表示)之间的关系。

结果

男性糖尿病和空腹血糖受损(IFG)的患病率分别为 13.9%和 30.6%,女性分别为 10.4%和 20.8%。使用多元线性回归分析,我们发现 baPWV 与年龄、性别、体重指数(BMI)、腰围(WC)、收缩压(BP)、舒张压、空腹血糖和甘油三酯密切相关。与最低 HOMA-IR 三分位 I 相比,在调整年龄、BMI、WC、性别、甘油三酯、收缩压、舒张压、吸烟、饮酒、嚼槟榔和体力活动后,动脉僵硬度的优势比(95%置信区间)分别为 HOMA-IR 三分位 II 和三分位 III 的 1.15(0.77-1.71)和 1.60(1.05-2.46)。使用调整年龄、收缩压、舒张压、BMI、WC 和甘油三酯的一般线性模型,与 IFG 组相比,男性糖尿病组的 baPWV 降低了 90.3cm/sec,女性降低了 100.5cm/sec。与正常血糖组相比,IFG 组男性的 baPWV 降低了 28.5cm/sec,女性降低了 14.4cm/sec。

结论

在中国中年成年人中,动脉僵硬度与胰岛素抵抗独立相关。糖尿病或 IFG 患者的 baPWV 高于血糖正常者。

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