Tan Ce, Sasagawa Yutaka, Mori Mitsuru
Department of Public Health Sapporo Medical University School of Medicine Sapporo Hokkaido Japan.
Rumoi Municipal Hospital Rumoi Hokkaido Japan.
J Gen Fam Med. 2017 Jun 15;18(6):360-364. doi: 10.1002/jgf2.94. eCollection 2017 Dec.
It has widely been proven that metabolic syndrome (MetS) increases the risk of ischemic heart disease (IHD). MetS is confirmed based upon insulin resistance (IR). Our aim of this study is to evaluate the role of MetS and IR in the prediction of IHD incidence.
A total of 404 non-diabetic participants who underwent 75 g oral glucose tolerance test (75 g OGTT) were enrolled from 2001 to 2009. Risk factors for IHD were measured as well. The homeostatic index of IR (HOMA-IR) and the homeostatic model assessment beta cell function (HOMA-β) were calculated according to the homeostasis model assessment. Cox proportional-hazard regression model was used to estimate hazard ratio (HR). All data were analyzed using SPSS 21 software (IBM, Armonk, NY, USA).
In our study, the average follow-up period was 6.7 years. Eighteen subjects of IHD incidence were recorded. After adjusting for age and sex, subjects with IR or hyperinsulinemia had a high risk of IHD, the hazard ratio (95% confidence intervals) for IHD were 4.58 (1.59-13.15), 4.25 (1.64-11.91), respectively. The highest hazard ratio was 7.56 (2.27-25.18) which was found among the subjects with both IR and hyperinsulinemia. In addition, the hazard ratio (95% confidence intervals) of subjects with MetS was 2.80(1.10-7.09).
IR and hyperinsulinemia are related to the risk of IHD. IR combined with hyperinsulinemia may be superior to MetS for predicting the IHD incidence.
大量研究已证实，代谢综合征（MetS）会增加缺血性心脏病（IHD）的发病风险。MetS是基于胰岛素抵抗（IR）来确诊的。本研究旨在评估MetS和IR在预测IHD发病率方面的作用。
2001年至2009年期间，共纳入404名接受75克口服葡萄糖耐量试验（75g OGTT）的非糖尿病参与者。同时还测量了IHD的危险因素。根据稳态模型评估计算胰岛素抵抗稳态指数（HOMA-IR）和稳态模型评估β细胞功能（HOMA-β）。采用Cox比例风险回归模型估计风险比（HR）。所有数据均使用SPSS 21软件（美国纽约州阿蒙克市IBM公司）进行分析。
在我们的研究中，平均随访期为6.7年。记录到18例IHD发病患者。在调整年龄和性别后，有IR或高胰岛素血症的受试者患IHD的风险较高，IHD的风险比（95%置信区间）分别为4.58（1.59 - 13.15）、4.25（1.64 - 11.91）。在同时患有IR和高胰岛素血症的受试者中发现最高风险比为7.56（2.27 - 25.18）。此外，患有MetS的受试者的风险比（95%置信区间）为2.80（1.10 - 7.09）。
IR和高胰岛素血症与IHD风险相关。IR与高胰岛素血症相结合在预测IHD发病率方面可能优于MetS。
