胰岛素抵抗与血液学参数的关系:一项从青春期到成年的队列研究。
Association between insulin resistance and haematological parameters: A cohort study from adolescence to adulthood.
机构信息
EPIUnit-Institute of Public Health, University of Porto, Porto, Portugal.
Department of Clinical Epidemiology, Predictive Medicine and Public Health, University of Porto Medical School, Porto, Portugal.
出版信息
Diabetes Metab Res Rev. 2019 Nov;35(8):e3194. doi: 10.1002/dmrr.3194. Epub 2019 Jul 16.
BACKGROUND
The aim of this study was to quantify the relationship between insulin resistance and haematological parameters from adolescence to adulthood.
METHODS
Participants from the EPITeen cohort were evaluated at 13, 17, and 21 years, through standardized procedures. A fasting blood sample was obtained, and insulin resistance was evaluated by the homeostatic model assessment (HOMA-IR). The cross-sectional association between HOMA-IR and haematological parameters at 21 years was quantified in 1671 participants by multivariate linear regression coefficients (β) and 95% confidence intervals (95%CI). For the longitudinal analysis (n = 496), trajectories of insulin and glucose were estimated using model-based clustering, and haematological parameters were compared according to trajectories using ANOVA.
RESULTS
At 21 years, after adjustment for BMI, positive associations (β [95%CI]) were found between HOMA-IR and red blood count (0.05 [0.03;0.07] in females; 0.02 [0.00;0.04] in males); and haematocrit (0.29 [0.12;0.46] in females; 0.21 [0.04,0.38] in males). In females, HOMA-IR was inversely associated with packed cell volume (PCV) (-0.35 [-0.66;-0.05]) and iron levels (-3.98 [-6.94,-1.03]) but positively associated with white blood cells (0.31 [0.19;0.43]) and platelets (7.66 [3.93;11.39]). In males, a higher HOMA-IR was significantly associated with higher haemoglobin (0.09 [0.03;0.16]). Regarding the longitudinal analysis, similar trends were found, but statistical significance was not reached.
CONCLUSIONS
Both longitudinal and cross-sectional analyses support the hypothesis that insulin resistance is associated with increased red blood cells count and haematocrit in young adults, even within normal ranges of insulin and glucose.
背景
本研究旨在定量评估青少年至成年期胰岛素抵抗与血液学参数之间的关系。
方法
EPITeen 队列的参与者在 13、17 和 21 岁时通过标准化程序进行评估。采集空腹血样,通过稳态模型评估(HOMA-IR)评估胰岛素抵抗。通过多元线性回归系数(β)和 95%置信区间(95%CI),在 1671 名参与者中定量评估了 21 岁时 HOMA-IR 与血液学参数的横断面相关性。对于纵向分析(n=496),使用基于模型的聚类估计胰岛素和血糖的轨迹,并使用方差分析比较根据轨迹的血液学参数。
结果
在 21 岁时,在调整 BMI 后,HOMA-IR 与红细胞计数呈正相关(女性:0.05 [0.03;0.07];男性:0.02 [0.00;0.04]);与血细胞比容呈正相关(女性:0.29 [0.12;0.46];男性:0.21 [0.04,0.38])。在女性中,HOMA-IR 与红细胞压积(PCV)呈负相关(-0.35 [-0.66;-0.05])和铁水平呈负相关(-3.98 [-6.94;-1.03]),但与白细胞呈正相关(0.31 [0.19;0.43])和血小板呈正相关(7.66 [3.93;11.39])。在男性中,较高的 HOMA-IR 与血红蛋白升高显著相关(0.09 [0.03;0.16])。关于纵向分析,发现了类似的趋势,但未达到统计学意义。
结论
纵向和横断面分析均支持胰岛素抵抗与年轻成年人红细胞计数和血细胞比容增加相关的假设,即使胰岛素和葡萄糖处于正常范围内也是如此。