脂肪组织胰岛素抵抗预示未来血管阻力：广岛葡萄糖代谢与心血管疾病研究。

Insulin resistance in the adipose tissue predicts future vascular resistance: The Hiroshima Study on Glucose Metabolism and Cardiovascular Diseases.

机构信息

Health Management and Promotion Center, Hiroshima Atomic Bomb Casualty Council, Hiroshima, Japan; Department of Regenerative Medicine, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan.

Health Management and Promotion Center, Hiroshima Atomic Bomb Casualty Council, Hiroshima, Japan.

出版信息

Atherosclerosis. 2024 Jun;393:117547. doi: 10.1016/j.atherosclerosis.2024.117547. Epub 2024 Apr 12.

DOI:10.1016/j.atherosclerosis.2024.117547

PMID:38703418

Abstract

BACKGROUND AND AIMS

Diameter, plaque score, and resistance index (RI) in the common carotid artery (CCA) are indicators of arterial remodeling, atherosclerosis, and vascular resistance, respectively. This study investigated the longitudinal association between adipose tissue insulin resistance or serum free fatty acid (FFA) levels and the CCA parameters.

METHODS

This retrospective cohort analysis included 1089 participants (mean age 57.6 years; 40.0 % women) with data on health checkups from January 1982 to March 2003 and carotid artery ultrasonography from January 2015 to June 2019. Baseline serum FFA and immunoreactive insulin levels were assessed before and 30, 60, and 120 min after glucose ingestion. Adipose insulin resistance index (Adipo-IR) was calculated as the product of fasting serum insulin and FFA levels. An RI value >0.75 was defined as high RI.

RESULTS

A significant association was found between Adipo-IR and RI; however, Adipo-IR showed no association with CCA diameter or plaque score. The incidence of high RI increased with Adipo-IR quartile (Q) groups (47.3 % in Q1, 52.8 % in Q2, 53.3 % in Q3, 62.4 % in Q4; Cochrane-Armitage test for trend, p < 0.001). In multivariate analysis, Adipo-IR levels (Q4 vs. Q1 odds ratio: 1.67, 95 % confidence interval: 1.12-2.51) were positively associated with high RI incidence. Moreover, a significant association was found between RI and serum FFA levels after glucose intake, but not fasting FFA levels.

CONCLUSIONS

Future vascular resistance was predicted by insulin resistance in the adipose tissue. After glucose intake, serum FFA levels may significantly impact vascular resistance development.

摘要

背景与目的

颈总动脉（CCA）的直径、斑块评分和阻力指数（RI）分别是动脉重构、动脉粥样硬化和血管阻力的指标。本研究探讨了脂肪组织胰岛素抵抗或血清游离脂肪酸（FFA）水平与 CCA 参数之间的纵向关联。

方法

本回顾性队列分析纳入了 1089 名参与者（平均年龄 57.6 岁，40.0%为女性），这些参与者的数据来自 1982 年 1 月至 2003 年 3 月的健康检查和 2015 年 1 月至 2019 年 6 月的颈动脉超声检查。在葡萄糖摄入前、摄入后 30、60 和 120 分钟时评估了基线血清 FFA 和免疫反应性胰岛素水平。脂肪组织胰岛素抵抗指数（Adipo-IR）是空腹血清胰岛素和 FFA 水平的乘积。RI 值>0.75 定义为高 RI。

结果

Adipo-IR 与 RI 之间存在显著关联，但 Adipo-IR 与 CCA 直径或斑块评分无关。高 RI 的发生率随 Adipo-IR 四分位（Q）组增加（Q1 为 47.3%，Q2 为 52.8%，Q3 为 53.3%，Q4 为 62.4%；Cochrane-Armitage 趋势检验，p<0.001）。多变量分析显示，Adipo-IR 水平（Q4 与 Q1 比值比：1.67，95%置信区间：1.12-2.51）与高 RI 发生率呈正相关。此外，在葡萄糖摄入后发现 RI 与血清 FFA 水平之间存在显著关联，但与空腹 FFA 水平无关。