Feskens E J, Loeber J G, Kromhout D
Department of Chronic Diseases and Environmental Epidemiology, National Institute of Public Health and Environmental Protection, Bilthoven, The Netherlands.
Am J Epidemiol. 1994 Aug 15;140(4):350-60. doi: 10.1093/oxfordjournals.aje.a117257.
The relation of dietary factors and physical activity to hyperinsulinemia was examined in 389 men aged 70-89 years who participated in the Zutphen Elderly Study in 1990. Information about the usual diet was obtained using a cross-check dietary history, and habitual physical activity was assessed using a validated questionnaire. Known and newly diagnosed diabetic patients were excluded from this study, since serum insulin and C-peptide levels are indicators of insulin resistance and hyperinsulinemia in non-diabetics only. Insulin levels during the oral glucose tolerance test were lowest in men with the highest physical activity. This inverse association was independent of age, body mass index, the ratio of subscapular to triceps skinfold thickness, cigarette smoking, and energy intake (p < 0.001). In addition, insulin levels were inversely associated with the intake of dietary fiber and polyunsaturated fatty acids, which could not be accounted for by variables such as energy intake, body mass index, physical activity, prescribed diets, or the presence of coronary heart disease. In contrast, insulin levels increased with the increasing intake of saturated fatty acids and alcohol. The fasting C-peptide level was independently associated with the intake of total fat, saturated and monounsaturated fatty acids, and alcohol, whereas an inverse relation with the intake of total carbohydrates and dietary fiber was seen. Besides overweight, physical activity and dietary factors such as the intake of fatty acids, fiber, carbohydrates, and alcohol, were independently associated with hyperinsulinemia and insulin resistance. Therefore, these behavioral factors may partly determine the occurrence of non-insulin-dependent diabetes mellitus and coronary heart disease and play a role in the prevention of these disorders.
1990年参加祖特芬老年研究的389名70至89岁男性接受了饮食因素和身体活动与高胰岛素血症关系的研究。通过交叉核对饮食史获取日常饮食信息，使用经过验证的问卷评估习惯性身体活动。已知和新诊断的糖尿病患者被排除在本研究之外，因为血清胰岛素和C肽水平仅是非糖尿病患者胰岛素抵抗和高胰岛素血症的指标。口服葡萄糖耐量试验期间，身体活动量最高的男性胰岛素水平最低。这种负相关独立于年龄、体重指数、肩胛下与三头肌皮褶厚度之比、吸烟和能量摄入（p<0.001）。此外，胰岛素水平与膳食纤维和多不饱和脂肪酸的摄入量呈负相关，这不能用能量摄入、体重指数、身体活动、规定饮食或冠心病的存在等变量来解释。相比之下，胰岛素水平随着饱和脂肪酸和酒精摄入量的增加而升高。空腹C肽水平与总脂肪、饱和和单不饱和脂肪酸以及酒精的摄入量独立相关，而与总碳水化合物和膳食纤维的摄入量呈负相关。除超重外，身体活动和饮食因素，如脂肪酸、纤维、碳水化合物和酒精的摄入量，与高胰岛素血症和胰岛素抵抗独立相关。因此，这些行为因素可能部分决定非胰岛素依赖型糖尿病和冠心病的发生，并在预防这些疾病中发挥作用。
