Corresponding author: Ying Zhang,
Diabetes Care. 2013 Oct;36(10):3195-200. doi: 10.2337/dc12-2368. Epub 2013 Jun 4.
Prevalence of insulin resistance is high in the American Indian population, likely as a result of the high prevalence of obesity. This condition may be influential for clinical outcomes such as cardiovascular disease (CVD) and decreased kidney function.
Normal glucose tolerant (NGT) participants free of hypertension and CVD at the baseline examination (1989-1992) (N=964) of the Strong Heart Study were selected to explore the cross-sectional association between insulin resistance quantified by homeostasis model assessment (HOMA-IR) and demographic, behavioral, and cardiometabolic variables. The longitudinal association between baseline HOMA-IR and the development of CVD was also explored. The longitudinal association between baseline HOMA-IR and the development of high urinary albumin-to-creatinine ratio was explored among nondiabetic participants (N=1,401).
Cross-sectionally, HOMA-IR was associated with sex, residence location, smoking, and high-risk cardiometabolic profile. Prospectively, insulin resistance is associated with the development of CVD and decreased kidney function in this population.
Insulin resistance may have an important role in the pathogenesis of CVD and chronic kidney disease. Since obesity contributes to the development of insulin resistance, intervention focusing on modifiable factors such as physical activity and weight control may reduce the development of these diseases.
印第安人群体中胰岛素抵抗的患病率很高，这可能是肥胖患病率高的结果。这种情况可能对心血管疾病 (CVD) 和肾功能下降等临床结果有影响。
选择在“强壮之心研究”的基线检查（1989-1992 年）中无高血压和 CVD 的正常糖耐量 (NGT) 参与者（N=964），以探索用稳态模型评估 (HOMA-IR) 量化的胰岛素抵抗与人口统计学、行为和心血管代谢变量之间的横断面关联。还探索了基线 HOMA-IR 与 CVD 发展之间的纵向关联。在非糖尿病参与者中（N=1,401），还探索了基线 HOMA-IR 与高尿白蛋白/肌酐比值发展之间的纵向关联。
横断面研究中，HOMA-IR 与性别、居住地点、吸烟和高风险心血管代谢特征有关。前瞻性研究表明，胰岛素抵抗与该人群 CVD 和肾功能下降的发展有关。
胰岛素抵抗可能在 CVD 和慢性肾病的发病机制中起重要作用。由于肥胖导致胰岛素抵抗的发展，因此针对身体活动和体重控制等可改变因素的干预措施可能会降低这些疾病的发展。
