Feskens E J, Kromhout D
National Institute of Public Health and Environmental Protection, Department of Chronic Diseases and Environmental Epidemiology, Bilthoven, Netherlands.
Arterioscler Thromb. 1994 Oct;14(10):1641-7. doi: 10.1161/01.atv.14.10.1641.
We investigated the association between fasting insulin concentration--an indicator of insulin resistance in nondiabetic individuals--cardiovascular risk factors, and coronary heart disease in a study of 390 men in the town of Zutphen. In 1990, an extensive examination was carried out on the participating men (aged 70 to 89 years). Fasting insulin levels were determined and a number of other risk factors measured. Known and newly diagnosed diabetics were excluded from the data analyses. Fasting insulin concentration was significantly associated with levels of glucose, triglycerides, uric acid, serum albumin, creatinine, and fibrinogen as well as resting heart rate. Inverse associations with high-density lipoprotein cholesterol and factor VII activity were observed. These results were independent of confounding factors such as age, body mass index, ratio of subscapular to triceps skinfold thicknesses, cigarette smoking, physical activity, and alcohol consumption. Men with a fasting insulin level higher than 80 pmol/L (highest quartile of the distribution) had a significantly higher prevalence of coronary heart disease and especially of myocardial infarction. This result was independent of potential confounding variables as well as of possible intermediates (total and high-density lipoprotein cholesterol, hypertension, serum triglycerides, fasting glucose, and other risk factors related to fasting insulin) (odds ratio, 2.2; 95% confidence interval, 1.2-4.0). No association between fasting insulin level and hypertension or blood pressure was observed. These results show that fasting insulin is an important indicator of coronary heart disease in elderly men. Clotting factors, resting heart rate, uric acid, serum albumin, and creatinine may also play a role in this metabolic syndrome.
在祖特芬镇对390名男性进行的一项研究中，我们调查了空腹胰岛素浓度（非糖尿病个体胰岛素抵抗的一个指标）与心血管危险因素及冠心病之间的关联。1990年，对参与研究的男性（年龄在70至89岁之间）进行了全面检查。测定了空腹胰岛素水平，并测量了一些其他危险因素。已知的和新诊断出的糖尿病患者被排除在数据分析之外。空腹胰岛素浓度与血糖、甘油三酯、尿酸、血清白蛋白、肌酐和纤维蛋白原水平以及静息心率显著相关。观察到与高密度脂蛋白胆固醇和因子VII活性呈负相关。这些结果不受年龄、体重指数、肩胛下与三头肌皮褶厚度之比、吸烟、体力活动和饮酒等混杂因素的影响。空腹胰岛素水平高于80 pmol/L（分布的最高四分位数）的男性患冠心病尤其是心肌梗死的患病率显著更高。这一结果不受潜在混杂变量以及可能的中间变量（总胆固醇和高密度脂蛋白胆固醇、高血压、血清甘油三酯、空腹血糖以及与空腹胰岛素相关的其他危险因素）的影响（比值比为2.2；95%置信区间为1.2 - 4.0）。未观察到空腹胰岛素水平与高血压或血压之间的关联。这些结果表明，空腹胰岛素是老年男性冠心病的一个重要指标。凝血因子、静息心率、尿酸、血清白蛋白和肌酐可能也在这种代谢综合征中起作用。
