Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA.
Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA.
J Clin Lipidol. 2017 Jul-Aug;11(4):1007-1012. doi: 10.1016/j.jacl.2017.05.013. Epub 2017 Jun 6.
Insulin resistance in apparently healthy persons is associated with a cluster of metabolic abnormalities that promote coronary atherosclerosis. Identifying these individuals before manifest disease would provide useful clinical information.
We hypothesized that combining 2 simple markers of insulin resistance, prediabetes (PreDM) and triglyceride (TG) concentration ≥150 mg/dL, would identify apparently healthy persons with adverse cardiometabolic risk profiles and increased coronary artery calcium (CAC) compared with those with neither or only 1 abnormality.
A cross-sectional analysis was performed using data from 25,886 apparently healthy individuals (18,453 men and 7433 women) evaluated at the Cooper Clinic from 1998 to 2015. Participants were divided into those with a normal fasting glucose concentrations (<100 mg/dL = normal fasting glucose) or PreDM (fasting plasma glucose ≥100 and <126 mg/dL) and further subdivided into those with a plasma TG concentration <150 or ≥150 mg/dL. These 4 groups were compared on the basis of multiple coronary artery disease risk factors and the presence of CAC determined during their evaluation.
Participants with PreDM and a TG concentration ≥150 mg/dL had a significantly more adverse coronary artery disease risk profile than individuals with either abnormality or only 1 abnormality (PreDM or TG concentration ≥150 mg/dL). Furthermore, the odds of detectable CAC were higher in participants with PreDM and a TG ≥ 150 mg/dL than in participants with neither or only 1 abnormality.
The presence of 2 markers of insulin resistance, PreDM and TG concentration ≥150 mg/dL, is associated with increased cardiometabolic risk and detectable CAC within a population of apparently healthy individuals.
在看似健康的人群中，胰岛素抵抗与促进冠状动脉粥样硬化的一系列代谢异常有关。在明显的疾病发生之前识别这些个体将提供有用的临床信息。
我们假设，将 2 种简单的胰岛素抵抗标志物（糖尿病前期（PreDM）和甘油三酯（TG）浓度≥150mg/dL）相结合，将识别出具有不良心血管代谢风险特征和增加冠状动脉钙（CAC）的看似健康的个体，与既没有也只有 1 种异常的个体相比。
使用 1998 年至 2015 年在库珀诊所接受评估的 25886 名看似健康个体（18453 名男性和 7433 名女性）的数据进行了横断面分析。参与者分为空腹血糖浓度正常（<100mg/dL=正常空腹血糖）或糖尿病前期（空腹血糖≥100 且<126mg/dL）的人群，进一步分为血浆 TG 浓度<150 或≥150mg/dL 的人群。根据他们评估期间的多种冠心病危险因素和 CAC 的存在，对这 4 组进行了比较。
患有糖尿病前期和 TG 浓度≥150mg/dL 的参与者的冠心病风险状况明显更差，比仅存在 1 种异常（糖尿病前期或 TG 浓度≥150mg/dL）或存在两种异常的参与者更差。此外，患有糖尿病前期和 TG≥150mg/dL 的参与者中 CAC 可检测的可能性高于既没有也只有 1 种异常的参与者。
在看似健康的人群中，存在 2 种胰岛素抵抗标志物，糖尿病前期和 TG 浓度≥150mg/dL，与代谢风险增加和 CAC 可检测有关。
