Sasaki Ryoma, Yano Yutaka, Yasuma Taro, Onishi Yuki, Suzuki Toshinari, Maruyama-Furuta Noriko, Gabazza Esteban C, Sumida Yasuhiro, Takei Yoshiyuki
Department of Diabetes, Metabolism and Endocrinology, Mie University Graduate School of Medicine, Japan.
Intern Med. 2016;55(11):1425-32. doi: 10.2169/internalmedicine.55.4100. Epub 2016 Jun 1.
Objective We investigated the relationship of the waist circumference (WC) and body fat weight (BF) with insulin resistance in subjects with normal body mass index (BMI) and normal glucose tolerance (NGT) during a routine medical check-up. Methods We categorized 167 male subjects in three groups as follows: a group with normal BMI but high WC (normal-BMI/high-WC group; 22≤BMI<25 kg/m(2), waist ≥85 cm; n=31), a group with normal BMI and normal WC (normal-BMI/normal-WC group, waist <85 cm; n=68), and a group with low normal BMI and normal WC (low normal-BMI/normal-WC group; 18.5≤BMI<22 kg/m(2) and waist<85 cm; n=68). We measured the plasma glucose and serum insulin levels before glucose loading and after 30 and 120 minutes and calculated several indexes of insulin secretion and sensitivity. Results Subjects from the normal-BMI/high-WC group showed significantly decreased Matsuda index and increased homeostasis model assessment for insulin resistance (HOMA-IR) compared with normal-BMI/normal-WC group. Univariate regression analyses showed significant correlation of HOMA-IR with WC (r=0.39) and BF (r=0.37). Matsuda index was significantly correlated with WC (r=-0.39) and BF (r=-0.47). The multiple regression analysis showed that the BF is significantly correlated with HOMA-IR (p<0.05) and Masuda index (p<0.005) among the clinical variables and with HOMA-IR (p<0.05) and Masuda index (p<0.0001) among the anthropometric variables but not with WC in either analysis. Conclusion Decreased Matsuda index and increased HOMA-IR were observed in subjects from the normal-BMI/high-WC group. Multivariate analysis showed that BF is associated with decreased Matsuda index and increased HOMA-IR and that WC is not associated with either factors.
目的 在一次常规体检中，我们调查了体重指数（BMI）正常且糖耐量正常（NGT）的受试者中，腰围（WC）和体脂重量（BF）与胰岛素抵抗之间的关系。方法 我们将167名男性受试者分为三组：BMI正常但WC高的组（正常BMI/高WC组；22≤BMI<25 kg/m²，腰围≥85 cm；n = 31），BMI正常且WC正常的组（正常BMI/正常WC组，腰围<85 cm；n = 68），以及BMI略低于正常范围且WC正常的组（低正常BMI/正常WC组；18.5≤BMI<22 kg/m²且腰围<85 cm；n = 68）。我们在葡萄糖负荷前、30分钟和120分钟后测量了血浆葡萄糖和血清胰岛素水平，并计算了几个胰岛素分泌和敏感性指标。结果 与正常BMI/正常WC组相比，正常BMI/高WC组的受试者松田指数显著降低，胰岛素抵抗稳态模型评估（HOMA-IR）增加。单变量回归分析显示HOMA-IR与WC（r = 0.39）和BF（r = 0.37）显著相关。松田指数与WC（r = -0.39）和BF（r = -0.47）显著相关。多元回归分析表明，在临床变量中，BF与HOMA-IR（p<0.05）和松田指数（p<0.005）显著相关，在人体测量变量中，BF与HOMA-IR（p<0.05）和松田指数（p<0.0001）显著相关，但在任何一项分析中均与WC无关。结论 在正常BMI/高WC组的受试者中观察到松田指数降低和HOMA-IR增加。多变量分析表明，BF与松田指数降低和HOMA-IR增加有关，而WC与这两个因素均无关。
