Haffner S M, Mykkänen L, Valdez R A, Stern M P
Department of Medicine, University of Texas Health Science Center at San Antonio 78284-7873.
Arterioscler Thromb. 1994 Sep;14(9):1430-7. doi: 10.1161/01.atv.14.9.1430.
Recent data suggest that proinsulin is associated with cardiovascular risk factors in nondiabetic and diabetic subjects. Since most conventional insulin assays cross-react with proinsulin, it has been suggested that the associations of insulin concentrations with dyslipidemia and hypertension could actually reflect associations with proinsulin. We examined these associations by using both a conventional immunoreactive insulin assay and a specific Linco insulin assay that does not cross-react with proinsulin in 623 nondiabetic and in 180 non-insulin-dependent diabetic subjects who participated in the San Antonio Heart Study, a population-based study of diabetes and cardiovascular disease. Both the immunoreactive insulin assay and the specific Linco insulin assay were equally correlated with cardiovascular risk factors in nondiabetic subjects. Insulin concentrations were moderately correlated with high triglyceride and low high-density lipoprotein cholesterol levels and were weakly correlated with increased blood pressure. In diabetic subjects there were only weak associations between insulin and cardiovascular risk factors using either assay. We conclude that the association of insulin concentrations with cardiovascular risk factors is not a function of using insulin assays that cross-react with proinsulin and that for epidemiological studies of cardiovascular risk factors, conventional immunoreactive insulin assays are as good as the newer specific insulin assays.
近期数据表明，胰岛素原与非糖尿病及糖尿病患者的心血管危险因素相关。由于大多数传统胰岛素检测方法会与胰岛素原发生交叉反应，因此有人提出，胰岛素浓度与血脂异常及高血压之间的关联实际上可能反映的是与胰岛素原的关联。我们在参与圣安东尼奥心脏研究（一项基于人群的糖尿病和心血管疾病研究）的623名非糖尿病患者和180名非胰岛素依赖型糖尿病患者中，使用传统免疫反应性胰岛素检测方法和不与胰岛素原发生交叉反应的特定林科胰岛素检测方法，对这些关联进行了研究。在非糖尿病患者中，免疫反应性胰岛素检测方法和特定林科胰岛素检测方法与心血管危险因素的相关性相同。胰岛素浓度与高甘油三酯和低高密度脂蛋白胆固醇水平呈中度相关，与血压升高呈弱相关。在糖尿病患者中，使用任何一种检测方法时，胰岛素与心血管危险因素之间仅有微弱关联。我们得出结论，胰岛素浓度与心血管危险因素之间的关联并非使用与胰岛素原发生交叉反应的胰岛素检测方法的结果，并且对于心血管危险因素的流行病学研究而言，传统免疫反应性胰岛素检测方法与更新的特定胰岛素检测方法一样好。
