Jiang X, Srinivasan S R, Webber L S, Wattigney W A, Berenson G S
Department of Applied Health Sciences, Tulane University School of Public Health and Tropical Medicine, New Orleans, La.
Arch Intern Med. 1995 Jan 23;155(2):190-6.
To assess whether circulating insulin is a major contributor to adverse lipid profiles during the transition from adolescence to young adulthood.
The association between fasting insulin levels and serum lipid and lipoprotein levels was examined in a cross-sectional survey of 4136 young individuals aged 5 to 30 years from a biracial community.
Fasting insulin levels were strongly and positively correlated with serum triglyceride and very-low-density lipoprotein cholesterol levels and negatively correlated with high-density lipoprotein cholesterol levels in all age groups (5 to 11, 12 to 17, 19 to 24, and 25 to 30 years). An increasing impact of insulin level on low-density lipoprotein cholesterol level was observed in young adults aged 25 to 30 years. In multivariate analysis, fasting insulin level was associated with very-low-density lipoprotein cholesterol level for most of the age groups in both races independently of age, sex, glucose levels, obesity, cigarette smoking, and alcohol intake. The independent relationship to low-density lipoprotein cholesterol level persisted in young adults aged 25 to 30 years. The independent and negative association with high-density lipoprotein cholesterol level remained in whites aged 5 to 24 years and blacks aged 19 to 24 years. When individuals were divided into tertiles according to insulin concentration and subscapular skinfold thickness, the independent effect of insulin level and obesity on lipoprotein fractions was also noted. Furthermore, a stronger association of insulin level with lipoprotein fractions was observed in obese than in lean white males.
These data indicate that an increasing association of insulin levels with adverse lipoprotein levels in young adults, especially obese individuals, may have adverse consequence for adult cardiovascular diseases.
评估在从青春期到青年期的过渡阶段，循环胰岛素是否是不良血脂谱的主要促成因素。
在一项对来自一个混血社区的4136名5至30岁年轻人的横断面调查中，研究空腹胰岛素水平与血清脂质和脂蛋白水平之间的关联。
在所有年龄组（5至11岁、12至17岁、19至24岁和25至30岁）中，空腹胰岛素水平与血清甘油三酯和极低密度脂蛋白胆固醇水平呈强正相关，与高密度脂蛋白胆固醇水平呈负相关。在25至30岁的年轻人中，观察到胰岛素水平对低密度脂蛋白胆固醇水平的影响越来越大。在多变量分析中，在两个种族的大多数年龄组中，空腹胰岛素水平与极低密度脂蛋白胆固醇水平相关，且独立于年龄、性别、血糖水平、肥胖、吸烟和饮酒。与低密度脂蛋白胆固醇水平的独立关系在25至30岁的年轻人中持续存在。与高密度脂蛋白胆固醇水平的独立负相关在5至24岁的白人以及19至24岁的黑人中仍然存在。当根据胰岛素浓度和肩胛下皮褶厚度将个体分为三分位数时，也注意到了胰岛素水平和肥胖对脂蛋白组分的独立影响。此外，在肥胖的白人男性中观察到胰岛素水平与脂蛋白组分的关联比瘦的白人男性更强。
这些数据表明，在年轻人尤其是肥胖个体中，胰岛素水平与不良脂蛋白水平之间的关联日益增加，可能对成人心血管疾病产生不良后果。
