Pyöräla K
Diabetes Care. 1979 Mar-Apr;2(2):131-41. doi: 10.2337/diacare.2.2.131.
The relationship of glucose tolerance to the incidence of coronary heart disease (CHD) has been investigated in two cohorts of Finnish men: 3267 men ages 40--59 yr from the Social Insurance Institution's (SII) Coronary Heart Disease Study and 1059 men ages 30--59 yr from the Helsinki Policemen Study. The relationship of plasma insulin level to the incidence of CHD was also investigated in the Helsinki Policemen Study. An oral glucose lead of 60, 75, or 90 g according to body surface area was used in both studies. In the SII Study, plasma glucose was determined from venous blood samples taken 1 h after glucose load. In the Helsinki Policemen Study, blood glucose was determined from venous blood samples taken at 0, 1, and 2 h, and at a 5-yr reexamination, plasma insulin was measured during OGTT at 0, 1, 2 h. In the SII Study cohort, the 4-yr mortality from CHD and the 4-yr incidence of nonfatal myocardial infarction (MI) did not show a definite relationship to 1-h postload plasma glucose. In the Helsinki Policemen Study cohort, the 5-yr incidence of "hard criteria" CHD (CHD death and nonfatal MI) was significantly related to high 1-h postload blood glucose level but not to fasting or 2-h postload blood glucose levels. 10-yr mortality from CHD was significantly higher in the top quintile of fasting and 1- and 2-h postload blood glucose levels, as was the incidence of "hard criteria" CHD. However, in multivariate analyses including age, systolic blood pressure, plasma cholesterol, and smoking, the blood glucose variables showed no statistically significant independent contribution in predicted risk of CHD. Univariate analyses by quintiles of plasma insulin levels measured at the 5-yr reexamination showed that the incidence of "hard criteria" CHD during the subsequent 5 yr was significantly higher in the top quintiles of fasting and 1-h and 2-h postload plasma insulin than in the combined lower quintiles. Multivariate analyses showed that the value of high 1-h or 2-h postload plasma insulin level for predicting CHD risk was independent of other risk factors, including blood glucose levels during OGTT.
在两组芬兰男性中研究了糖耐量与冠心病（CHD）发病率之间的关系：一组来自社会保险机构（SII）冠心病研究的3267名年龄在40 - 59岁的男性，另一组来自赫尔辛基警察研究的1059名年龄在30 - 59岁的男性。在赫尔辛基警察研究中还研究了血浆胰岛素水平与冠心病发病率之间的关系。两项研究均根据体表面积使用60、75或90克的口服葡萄糖负荷量。在SII研究中，在葡萄糖负荷后1小时采集静脉血样测定血浆葡萄糖。在赫尔辛基警察研究中，在0、1和2小时采集静脉血样测定血糖，并且在5年复查时，在口服葡萄糖耐量试验（OGTT）的0、1、2小时测量血浆胰岛素。在SII研究队列中，冠心病的4年死亡率和非致命性心肌梗死（MI）的4年发病率与负荷后1小时血浆葡萄糖没有明确关系。在赫尔辛基警察研究队列中，“严格标准”冠心病（冠心病死亡和非致命性MI）的5年发病率与负荷后1小时高血糖水平显著相关，但与空腹血糖或负荷后2小时血糖水平无关。空腹血糖以及负荷后1小时和2小时血糖水平处于最高五分位数的人群中，冠心病的10年死亡率以及“严格标准”冠心病的发病率均显著更高。然而，在包括年龄、收缩压、血浆胆固醇和吸烟情况的多变量分析中，血糖变量在预测冠心病风险方面未显示出统计学上显著的独立作用。在5年复查时按血浆胰岛素水平五分位数进行的单变量分析表明，在随后5年中，空腹血糖以及负荷后1小时和2小时血浆胰岛素处于最高五分位数的人群中，“严格标准”冠心病的发病率显著高于合并的较低五分位数人群。多变量分析表明，负荷后1小时或2小时血浆胰岛素水平升高对预测冠心病风险的价值独立于其他风险因素，包括OGTT期间的血糖水平。
