Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea.
Korean J Intern Med. 2011 Sep;26(3):285-93. doi: 10.3904/kjim.2011.26.3.285. Epub 2011 Sep 13.
BACKGROUND/AIMS: The objective of this study was to determine whether insulin resistance is associated with gallbladder stone formation in Korean women based on menopausal status.
The study included 4,125 consecutive Korean subjects (30-79 years of age). Subjects who had a medical history of diabetes, hypertension, dyslipidemia, other cardiovascular disorders, or hormone replacement therapy were excluded. The women were subdivided into two groups according to their menopausal status.
Analysis of premenopausal women showed no significant differences in the homeostasis model of assessment-insulin resistance (HOMA-IR) index between the two groups in terms of gallstone disease. The associations between the occurrence of gallbladder stones and age, obesity, abdominal obesity, hyperinsulinemia, and high HOMA-IR index were statistically significant in the analysis with postmenopausal women. In a multiple logistic regression analysis, low high density lipoprotein-cholesterol was an independent predictor of gallbladder stone formation in premenopausal women. However, the multiple logistic regression analysis also showed that age and HOMA-IR were significantly associated with gallbladder stone formation in postmenopausal women. In an additional analysis stratified by obesity, insulin resistance was a significant risk factor for gallbladder stone formation only in the abdominally obese premenopausal group.
Insulin resistance may be associated with gallbladder stone formation in Korean postmenopausal women with abdominal obesity.
背景/目的:本研究旨在根据绝经状态,确定胰岛素抵抗是否与韩国女性胆囊结石形成有关。
本研究纳入了 4125 名连续的韩国受试者(30-79 岁)。排除有糖尿病、高血压、血脂异常、其他心血管疾病或激素替代治疗病史的患者。根据绝经状态,将女性分为两组。
在分析绝经前女性时,两组间胆结石疾病的稳态模型评估-胰岛素抵抗(HOMA-IR)指数无显著差异。在分析绝经后女性时,胆囊结石的发生与年龄、肥胖、腹型肥胖、高胰岛素血症和高 HOMA-IR 指数之间存在统计学显著关联。多因素逻辑回归分析显示,低高密度脂蛋白胆固醇是绝经前女性胆囊结石形成的独立预测因子。然而,多因素逻辑回归分析还表明,年龄和 HOMA-IR 与绝经后女性胆囊结石形成显著相关。在按肥胖分层的进一步分析中,仅在腹型肥胖的绝经前组中,胰岛素抵抗是胆囊结石形成的显著危险因素。
胰岛素抵抗可能与韩国腹型肥胖绝经后女性的胆囊结石形成有关。