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胰岛素抵抗与首次发生严重心血管事件的10年估计风险

Insulin Resistance and Estimated 10-Year Risk of a First Hard Cardiovascular Event.

作者信息

Yang Zhen, Shi Jun-He, He Shan

机构信息

China Academy of Chinese Medical Sciences, Xiyuan Hospital, Beijing, 100091, China.

Peking University Traditional Chinese Medicine Clinical Medical School (Xiyuan), Beijing, 100091, China.

出版信息

Curr Med Sci. 2025 Feb;45(1):51-56. doi: 10.1007/s11596-025-00024-4. Epub 2025 Feb 25.

Abstract

OBJECTIVE

This study aimed to investigate the association between insulin resistance and the risk of cardiovascular disease.

METHODS

A cross-sectional study including 2128 participants aged 40-79 years was conducted using data from the National Health and Nutrition Examination Survey from 1999 to 2018. The quantitative insulin sensitivity check index (QUICKI) and homeostasis model assessment of β-cell function (HOMA-β) were used as independent variables. The 10-year risk of a first hard atherosclerotic cardiovascular event was used as the dependent variable, with other potential confounding factors considered. Multivariate linear regression models and smooth curve fitting were used to assess the associations between insulin resistance and 10-year risk.

RESULTS

A total of 2128 patients, comprising 1191 men and 937 women, were included in our analysis. The regression analyses revealed a negative correlation between the QUICKI score and the 10-year risk of a first hard atherosclerotic cardiovascular event [β = - 8.85, CI (- 15.77, - 1.93)] after adjusting for age, race, body mass index, systolic blood pressure, diastolic blood pressure, hypertension treatment, smoking, diabetes, and low-density lipoprotein cholesterol. Conversely, an increase in HOMA-β was associated with 10-year risk [β =  6.84, CI (0.45, 13.23)]. Gender-specific subgroup analysis indicated that the QUICKI had a β value of 0.077 (0.046, 0.108) for men and 0.080 (0.061, 0.094) for women.

CONCLUSION

This study demonstrated that increased insulin resistance is linked to an increased risk of cardiovascular disease.

摘要

目的

本研究旨在探讨胰岛素抵抗与心血管疾病风险之间的关联。

方法

利用1999年至2018年美国国家健康与营养检查调查的数据,开展了一项横断面研究,纳入了2128名年龄在40 - 79岁之间的参与者。将定量胰岛素敏感性检查指数(QUICKI)和β细胞功能的稳态模型评估(HOMA-β)作为自变量。将首次发生严重动脉粥样硬化性心血管事件的10年风险作为因变量,并考虑了其他潜在的混杂因素。采用多元线性回归模型和平滑曲线拟合来评估胰岛素抵抗与10年风险之间的关联。

结果

我们的分析共纳入了2128名患者,其中男性1191名,女性937名。回归分析显示,在调整了年龄、种族、体重指数、收缩压、舒张压、高血压治疗、吸烟、糖尿病和低密度脂蛋白胆固醇后,QUICKI评分与首次发生严重动脉粥样硬化性心血管事件的10年风险呈负相关[β = - 8.85,可信区间(- 15.77,- 1.93)]。相反,HOMA-β的升高与10年风险相关[β = 6.84,可信区间(0.45,13.23)]。按性别进行的亚组分析表明,QUICKI对男性的β值为0.077(0.046,0.108),对女性的β值为0.080(0.061,0.094)。

结论

本研究表明,胰岛素抵抗增加与心血管疾病风险增加有关。

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