Department of Nutrition, University of Montreal, Canada.
Eur J Prev Cardiol. 2013 Dec;20(6):1042-50. doi: 10.1177/2047487312460214. Epub 2012 Sep 5.
The association of insulin resistance (IR) with other cardiometabolic risk (CMR) factors in sub-Saharan Africans is poorly documented. This study examined the links between IR and the evolution of blood pressure (BP), glycaemia, serum lipids and abdominal obesity in the population of Benin.
Population-based longitudinal study.
This study initially included 541 apparently healthy Beninese adults (50% women) aged 25-60 years who were randomly selected in a large city, a small town and a rural area. After a baseline survey, our subjects were followed up after 2 years, and again at 4 years. IR based on homeostasis model assessment (HOMA), blood glucose, BP, waist circumference (WC), triglycerides, total cholesterol and HDL-cholesterol were measured. Complete data at the end of the follow-up periods was available for 416 subjects.
IR was more prevalent in women than in men (33.2% versus 17.8%) and it was generally associated with more adverse values of CMR factors, excepting BP. In controlling for baseline age, sex, WC, diet, lifestyle variables and WC changes; the relative risk (RR) of hyperglycemia over 4 years was as least 3-fold in IR subjects, compared to normal subjects. The RR of abdominal obesity was 5.3 (1.04-26.93) in IR women, compared to non-IR. The association of IR with the evolution of dyslipidemia was inconsistent, but IR tended to exacerbate low HDL-cholesterol.
Over 4 years, IR exacerbated hyperglycemia in both men and women, and abdominal obesity in women, but IR did not affect blood pressure. Further research on the link found between IR and dyslipidemia, particularly low HDL-C, is needed in sub-Saharan Africa.
胰岛素抵抗（IR）与撒哈拉以南非洲人群其他心血管代谢风险（CMR）因素之间的关联尚未得到充分记录。本研究检查了 IR 与血压（BP）、血糖、血清脂质和腹部肥胖在贝宁人群中的演变之间的关系。
基于人群的纵向研究。
本研究最初纳入了 541 名年龄在 25-60 岁之间的贝宁成年人（50%为女性），他们是在一个大城市、一个小镇和一个农村地区随机选择的。在基线调查后，我们的研究对象在 2 年后和 4 年后再次进行随访。IR 基于稳态模型评估（HOMA）、血糖、BP、腰围（WC）、甘油三酯、总胆固醇和高密度脂蛋白胆固醇进行测量。在随访结束时，共有 416 名受试者获得了完整的数据。
IR 在女性中比男性更为普遍（33.2%对 17.8%），并且通常与 CMR 因素的更不利值相关，除了 BP。在控制基线年龄、性别、WC、饮食、生活方式变量和 WC 变化后；IR 组在 4 年内发生高血糖的相对风险（RR）至少是正常组的 3 倍。与非 IR 组相比，IR 女性腹部肥胖的 RR 为 5.3（1.04-26.93）。IR 与血脂异常的演变之间的关联不一致，但 IR 倾向于加剧低 HDL-胆固醇。
在 4 年内，IR 加剧了男性和女性的高血糖症，以及女性的腹部肥胖症，但 IR 并未影响血压。在撒哈拉以南非洲地区，需要进一步研究 IR 与血脂异常（特别是低 HDL-C）之间的关联。
