Health Management and Promotion Center, Hiroshima Atomic Bomb Casualty Council.
Department of General Medicine, Hiroshima University Graduate School of Biomedical and Health Sciences.
J Atheroscler Thromb. 2022 May 1;29(5):654-666. doi: 10.5551/jat.62790. Epub 2021 May 19.
Diameter, intima-media thickness (IMT), and flow parameters, including resistance index (RI) and pulsatility index (PI), in the common carotid artery (CCA) are markers of arterial remodeling, atherosclerosis, and vascular resistance, respectively. We investigated the differences among these markers in association with plasma glucose level, serum insulin level, and insulin resistance in participants without cardiovascular disease.
CCA parameters (including the CCA interadventitial diameter and mean IMT at the time of 75-g oral glucose tolerance testing) were assessed in 4218 participants. RI and PI were assessed in 3380 of these participants. To assess plasma glucose and serum immunoreactive insulin profiles during oral glucose tolerance testing, we used the total areas under the curves (AUCglu and AUCins, respectively). We used the homeostasis model assessment of insulin resistance (HOMA-IR) and the Matsuda index to assess insulin resistance. Insulin secretion was assessed with the HOMA-β.
AUCglu was significantly associated with CCA interadventitial diameter (β=0.048, P<0.001), RI (β=0.144, P<0.001), and PI (β=0.103, P<0.001) but not with mean IMT. AUCins (β=-0.064, P<0.001) and HOMA-β (β=-0.054, P<0.001) were significantly and negatively associated with CCA interadventitial diameter, but not with mean IMT. Both HOMA-IR and Matsuda index were significantly associated with RI and PI.
These findings indicate that all CCA parameters except IMT are associated with impaired glucose metabolism in patients without cardiovascular disease.
颈总动脉(CCA)的直径、内膜中层厚度(IMT)和血流参数,包括阻力指数(RI)和搏动指数(PI),分别是动脉重构、动脉粥样硬化和血管阻力的标志物。我们研究了这些标志物与无心血管疾病患者的血浆葡萄糖水平、血清胰岛素水平和胰岛素抵抗之间的差异。
在 4218 名参与者中评估了 CCA 参数(包括 75g 口服葡萄糖耐量试验时的 CCA 内-中膜直径和平均 IMT)。在其中的 3380 名参与者中评估了 RI 和 PI。为了评估口服葡萄糖耐量试验期间的血浆葡萄糖和血清免疫反应性胰岛素谱,我们使用了曲线下总面积(AUCglu 和 AUCins,分别)。我们使用稳态模型评估的胰岛素抵抗(HOMA-IR)和 Matsuda 指数来评估胰岛素抵抗。用 HOMA-β评估胰岛素分泌。
AUCglu 与 CCA 内-中膜直径(β=0.048,P<0.001)、RI(β=0.144,P<0.001)和 PI(β=0.103,P<0.001)显著相关,但与平均 IMT 不相关。AUCins(β=-0.064,P<0.001)和 HOMA-β(β=-0.054,P<0.001)与 CCA 内-中膜直径显著负相关,但与平均 IMT 不相关。HOMA-IR 和 Matsuda 指数均与 RI 和 PI 显著相关。
这些发现表明,无心血管疾病患者中,所有 CCA 参数均与葡萄糖代谢受损相关,而 IMT 除外。