Mihai Bogdan Mircea, Petriş Antoniu Octavian, Ungureanu Didona Anca, Lăcătuşu Cristina Mihaela
Discipline of Diabetes, Nutrition and Metabolic Diseases, First Medical Department, University of Medicine and Pharmacy "Grigore T. Popa", 16th Universităţii Street, 700115, Iaşi, Romania.
Discipline of Internal Medicine and Cardiology, First Medical Department, University of Medicine and Pharmacy "Grigore T. Popa", 16th Universităţii Street, 700115, Iaşi, Romania.
Open Med (Wars). 2014 Sep 26;10(1):14-24. doi: 10.1515/med-2015-0003. eCollection 2015.
Cardiovascular risk of prediabetes is still subject to controversies. We analyzed the associations between insulin resistance, adipokines and incipient atherosclerosis estimated by intima-media thickness (IMT) in a cross-sectional study on 122 prediabetic subjects without clinical signs of atherosclerotic disease. Homeostasis model assessment of insulin resistance (HOMA-IR, calculated as fasting insulin × fasting plasma glucose / 22.5), adiponectin, leptin, leptin-to-adiponectin ratio, carotid and femoral IMT were evaluated. We also assessed other parameters related to insulin resistance and adipokines (HbA, anthropometric and lipid parameters), as they may also influence atherosclerosis. Carotid IMT was correlated to adiponectin and leptin-to-adiponectin ratio (all p < 0.05), but not with HOMA-IR or leptin, while femoral IMT showed no relationship with these factors. After adjusting for leptin, leptin-to-adiponectin ratio, triglycerides, HDL-cholesterol, cholesterol-to-HDL ratio, triglycerides-to-HDL ratio and HbA, IMT values became correlated with HOMA-IR. Adjustment for HOMA-IR induced the appearance of new correlations between adipokines and both IMT values. In conclusion, insulin resistance and adipokines seem related to IMT in prediabetic subjects without clinical signs of arterial obstruction.
糖尿病前期的心血管风险仍存在争议。在一项针对122名无动脉粥样硬化疾病临床症状的糖尿病前期患者的横断面研究中，我们分析了胰岛素抵抗、脂肪因子与通过内膜中层厚度（IMT）评估的早期动脉粥样硬化之间的关联。评估了胰岛素抵抗的稳态模型评估（HOMA-IR，计算方法为空腹胰岛素×空腹血糖/22.5）、脂联素、瘦素、瘦素与脂联素比值、颈动脉和股动脉IMT。我们还评估了与胰岛素抵抗和脂肪因子相关的其他参数（糖化血红蛋白、人体测量和血脂参数），因为它们也可能影响动脉粥样硬化。颈动脉IMT与脂联素和瘦素与脂联素比值相关（所有p<0.05），但与HOMA-IR或瘦素无关，而股动脉IMT与这些因素无相关性。在调整瘦素、瘦素与脂联素比值、甘油三酯、高密度脂蛋白胆固醇、胆固醇与高密度脂蛋白比值、甘油三酯与高密度脂蛋白比值和糖化血红蛋白后，IMT值与HOMA-IR相关。对HOMA-IR进行调整后，脂肪因子与两个IMT值之间出现了新的相关性。总之，在无动脉阻塞临床症状的糖尿病前期患者中，胰岛素抵抗和脂肪因子似乎与IMT相关。
