[胰岛素相关指标在超重成年人身体脂肪与血压关联中的中介作用]

[Mediating effect of insulin related indices on the association between body fat with blood pressure among overweight adults].

作者信息

Yang Yide, Yang Yiting, Fu Lianguo, Wang Shuo, Cong Renhuai, Wang Xiaoling, Wang Zhenghe, Ma Dongmei, Ma Rui, Zou Ziyong, Ma Jun

机构信息

School of Public Health & Institute of Child and Adolescent Health, Peking University, Beijing 100191, China.

出版信息

Zhonghua Yu Fang Yi Xue Za Zhi. 2016 Mar;50(3):225-9. doi: 10.3760/cma.j.issn.0253-9624.2016.03.007.

DOI:10.3760/cma.j.issn.0253-9624.2016.03.007

PMID:26957239

Abstract

OBJECTIVE

To examine the contribution of insulin related indices on the association between body fat and blood pressure among overweight adults.

METHODS

From April to May 2014, based on convenience sampling, we recruited overweight and obese volunteer participants aged 20-55 years living in Beijing at least 1 year through a strict examination by doctors in a physical examination center. In this study, we excluded the participants who reported suffering from any severe heart, lung, liver or kidney organic diseases, and abnormal development, disabilities, and secondary obesity caused by other disease. Also participants with use of antihypertensive drugs, hypoglycemic drugs and lipid lowering drugs were excluded for this study. A total of 1 221 participants were investigated in this study. With a simple self-designed questionnaire, the birthdates, sex, drug use, and disease history were examined. Participants' blood pressure (BP), percentage of body fat (PBF), glucose and fasting insulin level were measured. Mediation analysis was used to analyze the total effect of PBF on BP (c), the association between PBF and insulin related indices (a), and the mediation effect of serum fasting insulin level/HOMA-IR/HOMA-%S on relation between PBF and systolic/diastolic blood pressure (SBP/DBP).

RESULTS

PBF was positively associated with SBP (c=0.25 ± 0.05 and 0.19 ± 0.03 for male and female, respectively, P<0.001). In males, PBF was positively associated with fasting insulin level and HOMA-IR (a=0.28 ± 0.05 and 0.24 ± 0.05, P<0.001), and negatively associated with HOMA-%S (a=-0.29 ± 0.05, P<0.001); in females, PBF was positively associated with fasting insulin level, HOMA-IR (a=0.21 ± 0.04 and 0.20 ± 0.04, P<0.001), and negatively associated with HOMA-%S (a=-0.13 ± 0.04, P<0.001). In further mediation analysis for female participants, fasting insulin level/HOMA-IR/HOMA-%S played mediation roles in the relation between PBF and SBP, with ratio of mediation of 13.78%,18.3%, and 5.98%. Fasting insulin level/HOMA-IR also mediated the relation between PBF and DBP, with mediation ratio of 11.98% and 14.13%.

CONCLUSION

In overweight/obese female participants, insulin related indices mediated the relation between PBF and BP.

摘要

目的

探讨胰岛素相关指标在超重成年人身体脂肪与血压关联中的作用。

方法

2014年4月至5月，基于便利抽样，我们通过体检中心医生的严格检查，招募了居住在北京至少1年的20 - 55岁超重和肥胖志愿者参与者。在本研究中，我们排除了报告患有任何严重心、肺、肝或肾器质性疾病、发育异常、残疾以及由其他疾病引起的继发性肥胖的参与者。同时，本研究也排除了正在使用抗高血压药物、降糖药物和降脂药物的参与者。本研究共调查了1221名参与者。通过一份简单的自行设计问卷，调查了出生日期、性别、用药情况和疾病史。测量了参与者的血压（BP）、体脂百分比（PBF）、血糖和空腹胰岛素水平。采用中介分析来分析PBF对BP的总效应（c）、PBF与胰岛素相关指标的关联（a），以及血清空腹胰岛素水平/HOMA - IR/HOMA - %S对PBF与收缩压/舒张压（SBP/DBP）关系的中介效应。

结果

PBF与SBP呈正相关（男性c = 0.25±0.05，女性c = 0.19±0.03，P < 0.001）。在男性中，PBF与空腹胰岛素水平和HOMA - IR呈正相关（a = 0.28±0.05和0.24±0.05，P < 0.001），与HOMA - %S呈负相关（a = - 0.29±0.05，P < 0.001）；在女性中，PBF与空腹胰岛素水平、HOMA - IR呈正相关（a = 0.21±0.04和0.20±0.04，P < 0.001），与HOMA - %S呈负相关（a = - 0.13±0.04，P < 0.001）。在对女性参与者的进一步中介分析中，空腹胰岛素水平/HOMA - IR/HOMA - %S在PBF与SBP的关系中起中介作用，中介比例分别为13.78%、18.3%和5.98%。空腹胰岛素水平/HOMA - IR也介导了PBF与DBP的关系，中介比例分别为11.98%和14.13%。