冠状动脉痉挛性心绞痛与胰岛素抵抗相关——可能涉及内皮功能障碍。

Coronary spastic angina is associated with insulin resistance - possible involvement of endothelial dysfunction.

作者信息

Kashiwagi Yusuke, Harada Eisaku, Mizuno Yuji, Morita Sumio, Shono Makoto, Murohara Toyoaki, Yoshimura Michihiro, Yasue Hirofumi

机构信息

aDivision of Cardiovascular Medicine, Kumamoto Kinoh Hospital, Kumamoto Aging Research Institute, Kumamoto City bDepartment of Internal Medicine, Division of Cardiology, The Jikei University School of Medicine, Tokyo cDepartment of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan.

出版信息

Coron Artery Dis. 2013 Nov;24(7):559-65. doi: 10.1097/MCA.0000000000000024.

DOI:10.1097/MCA.0000000000000024

PMID:23965946

Abstract

OBJECTIVE

In this study, we examined whether coronary spastic angina (CSA) is associated with insulin resistance.

BACKGROUND

There is increasing evidence that insulin resistance is associated with endothelial dysfunction. Patients with CSA show endothelial dysfunction.

METHODS

The study participants include 111 CSA patients (81 men and 30 women, mean age 62±12 years) and 53 participants without CSA (24 men and 29 women, mean age 63±10 years), serving as the controls. The oral glucose tolerance test was performed, and anthropometric parameters, plasma glucose and insulin levels, lipid profiles, and other laboratory parameters were evaluated.

RESULTS

Homeostasis model assessment of insulin resistance (HOMA-IR), Log HOMA-IR, the quantitative insulin sensitivity check index, the insulin sensitivity index, and insulin resistance 60-120 min after glucose load (log post-glucose-IR) were calculated as surrogate markers of insulin resistance. The number of men, the number of smokers, log post-glucose-IR, the insulin sensitivity index, and fasting plasma glucose levels were higher in CSA patients compared with controls (P=0.001, 0.001, 0.004, 0.012, and 0.013, respectively), whereas plasma high-density lipoprotein cholesterol levels were lower (P<0.001).

CONCLUSION

Insulin resistance on glucose load (log post-glucose-IR), plasma high-density lipoprotein cholesterol levels, and smoking were significantly associated with CSA (r=0.225, P=0.004; r=-0.313, P<0.001; and r=0.258, P=0.001, respectively).

摘要

目的

在本研究中，我们探讨了冠状动脉痉挛性心绞痛（CSA）是否与胰岛素抵抗相关。

背景

越来越多的证据表明胰岛素抵抗与内皮功能障碍有关。CSA患者存在内皮功能障碍。

方法

研究参与者包括111例CSA患者（81例男性和30例女性，平均年龄62±12岁）和53例无CSA的参与者（24例男性和29例女性，平均年龄63±10岁）作为对照。进行口服葡萄糖耐量试验，并评估人体测量参数、血浆葡萄糖和胰岛素水平、血脂谱及其他实验室参数。

结果

计算胰岛素抵抗的稳态模型评估（HOMA-IR）、Log HOMA-IR、定量胰岛素敏感性检查指数、胰岛素敏感性指数以及葡萄糖负荷后60 - 120分钟的胰岛素抵抗（log post-glucose-IR）作为胰岛素抵抗的替代指标。与对照组相比，CSA患者的男性数量、吸烟者数量、log post-glucose-IR、胰岛素敏感性指数和空腹血糖水平更高（分别为P = 0.001、0.001、0.004、0.012和0.013），而血浆高密度脂蛋白胆固醇水平更低（P < 0.001）。