Sandeep S, Gokulakrishnan K, Deepa M, Mohan V
Department of Epidemiology, Madras Diabetes Research Foundation, Chennai.
J Assoc Physicians India. 2011 Aug;59:480-4.
The aim of the study was to assess the association of Insulin Resistance [IR] assessed by Homeostasis Assessment model (HOMA-IR) with cardiovascular risk factors in subjects with Normal Glucose Tolerance [NGT] in Asian Indians.
This cross-sectional study recruited subjects from the Chennai Urban Rural Epidemiology Study [CURES] an epidemiological study in a representative population of Chennai [formerly Madras], in South India. We included 1550 subjects with normal glucose tolerance, ie, fasting plasma glucose < 100 mg/dl [5.6 mmol/L] and 2 hour post load plasma glucose < 140 mg/dl [7.8 mmol/L]. IR was calculated using the homeostasis assessment model (HOMA-IR) using the formula: fasting insulin (1IU/mL) fasting glucose (mmol/L)/22.5. Metabolic syndrome [MS] was defined based on modified Adult Treatment Panel III (ATP III) guidelines.
HOMA-IR was found to be significantly associated with systolic blood pressure (beta = 0.100, p < 0.001), diastolic pressure (beta = 0.094, p < 0.001), total cholesterol (beta = 0.068, p = 0.005), serum triglycerides (beta = 0.105, p < 0.001), LDL cholesterol (beta = 0.118, p < 0.005), and HDL cholesterol (beta = -0.060, p < 0.001) even after adjusting age, gender and BMI. Subjects with family history of type 2 diabetes had significantly higher HOMA-IR [p = 0.011] compared to those without family history. In relation to physical activity, subjects with heavy grade activity had significantly lower HOMA-IR values compared to the light grade activity [p < 0.001] Subjects with generalized obesity [p < 0.001] and abdominal obesity [p < 0.001] had significantly higher HOMA-IR which remained statistically significant even after adjusting for age and gender. There was a linear increase in the mean values of HOMA IR with increase in number of components of MS [p for trend < 0.001]
Among Asian Indians who are known to have high risk of premature coronary artery disease and diabetes, a significant association exists between insulin resistance with cardiovascular risk factors even among NGT subjects.
本研究旨在评估在亚洲印度人中，通过稳态评估模型（HOMA-IR）评估的胰岛素抵抗（IR）与糖耐量正常（NGT）受试者心血管危险因素之间的关联。
这项横断面研究从金奈城乡流行病学研究（CURES）中招募受试者，该研究是针对印度南部金奈（原马德拉斯）代表性人群开展的一项流行病学研究。我们纳入了1550名糖耐量正常的受试者，即空腹血浆葡萄糖<100mg/dl[5.6mmol/L]且负荷后2小时血浆葡萄糖<140mg/dl[7.8mmol/L]。使用稳态评估模型（HOMA-IR），通过公式：空腹胰岛素（1IU/mL）×空腹血糖（mmol/L）/22.5来计算IR。代谢综合征（MS）根据修改后的成人治疗小组第三次报告（ATP III）指南进行定义。
即使在调整年龄、性别和体重指数（BMI）后，发现HOMA-IR与收缩压（β=0.100，p<0.001）、舒张压（β=0.094，p<0.001）、总胆固醇（β=0.068，p=0.005）、血清甘油三酯（β=0.105，p<0.001）、低密度脂蛋白胆固醇（β=0.118，p<0.005）和高密度脂蛋白胆固醇（β=-0.060，p<0.001）显著相关。有2型糖尿病家族史的受试者的HOMA-IR显著高于无家族史者[p=0.011]。在体力活动方面，重度活动的受试者的HOMA-IR值显著低于轻度活动者[p<0.001]。全身肥胖者[p<0.001]和腹型肥胖者[p<0.001]的HOMA-IR显著更高，即使在调整年龄和性别后仍具有统计学意义。随着MS组分数量的增加，HOMA-IR的平均值呈线性增加[p趋势<0.001]
在已知有早发冠状动脉疾病和糖尿病高风险的亚洲印度人中，即使在NGT受试者中，胰岛素抵抗与心血管危险因素之间也存在显著关联。
