Division of Cardiology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea.
Cardiovasc Diabetol. 2011 Nov 30;10:108. doi: 10.1186/1475-2840-10-108.
There is controversy about the specific pathophysiology of metabolic syndrome (MS) but several authors have argued that hyperinsulinemia is a key feature of the cluster. We aimed to assess whether the baseline insulin levels could predict the development of MS in a well characterised cohort of otherwise healthy adults who were followed over a five year period.
We identified 2, 350 Koreans subjects who did not have MS in 2003 and who were followed up in 2008. The subjects were divided into 4 groups according to the baseline quartiles of fasting insulin, and the predictors of the incidence of MS were analyzed using multivariate regression analysis.
Over the follow up period, 8.5% of the cohort developed MS. However, 16.4% of the subjects in the highest quartile of the insulin levels developed MS. In a model that included gender, age, the smoking status, the exercise level, alcohol consumption and the systolic blood pressure, the subjects in the highest quartile of the insulin levels had more than a 5 times greater risk of developing MS compared that of the subjects in the lowest quartile. This predictive importance remained significant even after correcting for all the individual features of MS.
These data suggest that high baseline fasting insulin levels are independent determinants for the future development of MS.
代谢综合征（MS）的具体病理生理学存在争议，但有几位作者认为高胰岛素血症是该综合征的一个关键特征。我们旨在评估在一个经过良好特征描述的、无 MS 的成年人队列中，基线胰岛素水平是否可以预测在五年随访期间 MS 的发生。
我们确定了 2003 年没有 MS 的 2350 名韩国人作为研究对象，并在 2008 年进行了随访。根据空腹胰岛素的基线四分位数，将受试者分为 4 组，使用多变量回归分析来分析 MS 发生率的预测因素。
在随访期间，8.5%的队列发生了 MS。然而，胰岛素水平最高四分位数的受试者中，有 16.4%发生了 MS。在包括性别、年龄、吸烟状况、运动水平、饮酒和收缩压在内的模型中，胰岛素水平最高四分位数的受试者发生 MS 的风险是最低四分位数受试者的 5 倍以上。即使校正了 MS 的所有个体特征后，这种预测的重要性仍然显著。
这些数据表明，高基线空腹胰岛素水平是 MS 未来发展的独立决定因素。
