Laakso M, Pyörälä K, Voutilainen E, Marniemi J
Am J Epidemiol. 1987 Apr;125(4):611-21. doi: 10.1093/oxfordjournals.aje.a114574.
The relationship between fasting plasma insulin and serum lipid and lipoprotein levels was studied in 1982-1983 in Kuopio, East Finland in 225 patients with non-insulin-dependent diabetes mellitus (119 men and 106 women) and 124 non-diabetic controls (65 men and 59 women). Compared to the non-diabetic controls, diabetic subjects showed significantly lower levels of high density lipoprotein (HDL) cholesterol and high density lipoprotein2 (HDL2) cholesterol and higher levels of total triglycerides and very low density lipoprotein (VLDL) triglycerides. Fasting plasma insulin correlated significantly with total triglycerides and VLDL triglycerides and negatively with HDL cholesterol and HDL2 cholesterol in both male and female diabetic subjects and non-diabetic control subjects. The correlation between fasting plasma insulin and HDL cholesterol remained statistically significant in non-insulin-dependent diabetic subjects and in female non-diabetic control subjects after adjustment for body mass index, alcohol intake, physical activity, smoking, and fasting plasma glucose. The correlation between fasting plasma insulin and total triglycerides remained significant after adjustment for these variables only in females. By multiple stepwise linear regression analysis, fasting plasma insulin had an independent association with HDL cholesterol in female non-diabetic control subjects and in male diabetic subjects and with triglycerides in female non-diabetic control subjects and in female diabetic subjects. The results show that hyperinsulinemia is related to low HDL cholesterol and HDL2 cholesterol and high total triglycerides and VLDL triglycerides in both non-insulin-dependent diabetic subjects and non-diabetic control subjects. This effect of hyperinsulinemia on lipid and lipoprotein patterns may be one explanation why high plasma insulin can promote accelerated atherosclerosis, particularly in patients with non-insulin-dependent diabetes mellitus.
1982 - 1983年，在芬兰东部的库奥皮奥，对225例非胰岛素依赖型糖尿病患者（119名男性和106名女性）和124名非糖尿病对照者（65名男性和59名女性）进行了空腹血浆胰岛素与血脂及脂蛋白水平关系的研究。与非糖尿病对照者相比，糖尿病患者的高密度脂蛋白（HDL）胆固醇和高密度脂蛋白2（HDL2）胆固醇水平显著降低，总甘油三酯和极低密度脂蛋白（VLDL）甘油三酯水平升高。在男性和女性糖尿病患者以及非糖尿病对照者中，空腹血浆胰岛素与总甘油三酯和VLDL甘油三酯显著相关，与HDL胆固醇和HDL2胆固醇呈负相关。在调整体重指数、酒精摄入量、体力活动、吸烟和空腹血糖后，非胰岛素依赖型糖尿病患者和女性非糖尿病对照者中，空腹血浆胰岛素与HDL胆固醇之间的相关性仍具有统计学意义。仅在女性中，调整这些变量后，空腹血浆胰岛素与总甘油三酯之间的相关性仍显著。通过多元逐步线性回归分析，空腹血浆胰岛素在女性非糖尿病对照者和男性糖尿病患者中与HDL胆固醇独立相关，在女性非糖尿病对照者和女性糖尿病患者中与甘油三酯独立相关。结果表明，高胰岛素血症与非胰岛素依赖型糖尿病患者和非糖尿病对照者的低HDL胆固醇、HDL2胆固醇以及高总甘油三酯和VLDL甘油三酯有关。高胰岛素血症对脂质和脂蛋白模式的这种影响可能是高血浆胰岛素可促进动脉粥样硬化加速发展的一个原因，尤其是在非胰岛素依赖型糖尿病患者中。
