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肝胰岛素抵抗与心血管危险因素的关系。

Association between liver insulin resistance and cardiovascular risk factors.

机构信息

Department of Medicine, University of Eastern Finland and Kuopio University Hospital, Kuopio.

出版信息

J Intern Med. 2012 Oct;272(4):402-8. doi: 10.1111/j.1365-2796.2012.02540.x. Epub 2012 Apr 19.

Abstract

OBJECTIVES

The objective of this study was to examine the associations between indices of liver insulin resistance (IR) and whole-body insulin sensitivity and different cardiovascular disease (CVD) risk factors.

DESIGN AND SUBJECTS

A total of 8750 nondiabetic men (age 57.2 ± 7.1 years, body mass index 26.8 ± 3.8 kg m(-2) ) were included in this study from the population-based cross-sectional Metabolic Syndrome In Men (METSIM) cohort. Liver IR index and Matsuda insulin sensitivity index (ISI) were used as markers of liver IR and whole-body insulin sensitivity, respectively. Pearson correlation analysis was performed to examine the associations between these indices and various CVD risk factors.

RESULTS

Total cholesterol (r = -0.088 vs. r = 0.020; P < 0.0019), high-sensitivity C-reactive protein (CRP) (r = 0.284 vs. r = -0.219; P < 0.0019) and total triglycerides (r = 0.507 vs. r = -0.477; P < 0.05) were more highly correlated with liver IR index than with Matsuda ISI. By contrast, Matsuda ISI was nominally more highly correlated with systolic and diastolic blood pressure (r = -0.234 and r = -0.275 vs. r = 0.202 and r = 0.239, respectively) compared to liver IR index. Furthermore, the variance explained by liver IR index was larger than that explained by Matsuda ISI for the majority of CVD risk factors measured.

CONCLUSIONS

Liver IR index correlated more strongly than Matsuda ISI with levels of total cholesterol, CRP and triglycerides. Therefore, liver IR might be a significant indicator of CVD risk amongst men.

摘要

目的

本研究旨在探讨肝脏胰岛素抵抗(IR)指数与全身胰岛素敏感性与不同心血管疾病(CVD)危险因素之间的关系。

设计和研究对象

本研究共纳入 8750 名非糖尿病男性(年龄 57.2±7.1 岁,体重指数 26.8±3.8kg/m²),来自基于人群的男性代谢综合征(METSIM)队列的横断面研究。采用肝脏 IR 指数和 Matsuda 胰岛素敏感性指数(ISI)分别作为肝脏 IR 和全身胰岛素敏感性的标志物。采用 Pearson 相关分析来检测这些指数与各种 CVD 危险因素之间的关系。

结果

总胆固醇(r=-0.088 与 r=0.020;P<0.0019)、高敏 C 反应蛋白(CRP)(r=0.284 与 r=-0.219;P<0.0019)和总甘油三酯(r=0.507 与 r=-0.477;P<0.05)与肝脏 IR 指数的相关性高于与 Matsuda ISI 的相关性。相比之下,Matsuda ISI 与收缩压和舒张压的相关性略高(r=-0.234 和 r=-0.275 与 r=0.202 和 r=0.239,分别),而与肝脏 IR 指数相比。此外,对于测量的大多数 CVD 危险因素,肝脏 IR 指数解释的方差大于 Matsuda ISI 解释的方差。

结论

肝脏 IR 指数与总胆固醇、CRP 和甘油三酯水平的相关性强于 Matsuda ISI。因此,肝脏 IR 可能是男性 CVD 风险的重要指标。

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