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高胰岛素血症是慢性心血管危险因素聚集综合征的核心特征吗?亚洲印度人、克里奥尔人和毛里求斯华人的混合研究结果。毛里求斯非传染性疾病研究小组。

Is hyperinsulinaemia a central characteristic of a chronic cardiovascular risk factor clustering syndrome? Mixed findings in Asian Indian, Creole and Chinese Mauritians. Mauritius Noncommunicable Disease Study Group.

作者信息

Zimmet P Z, Collins V R, Dowse G K, Alberti K G, Tuomilehto J, Knight L T, Gareeboo H, Chitson P, Fareed D

机构信息

International Diabetes Institute, Caulfield General Medical Centre, Victoria, Australia.

出版信息

Diabet Med. 1994 May;11(4):388-96. doi: 10.1111/j.1464-5491.1994.tb00291.x.

Abstract

The aim of the study was to investigate whether the constellation of cardiovascular disease risk factors, described as Insulin Resistance Syndrome, exists in the multi-ethnic population of Mauritius, and to assess whether hyperinsulinaemia is the key feature of this syndrome. A sample of 5080 Mauritian subjects (aged 25-74 years) was examined in a noncommunicable diseases survey in 1987. Survey procedure included an oral glucose tolerance test, and anthropometric, blood pressure, plasma lipids and serum insulin measurements. Abnormal glucose tolerance (diabetes and impaired glucose tolerance), general obesity, upper-body obesity, hypertension, low HDL-cholesterol, and hypertriglyceridaemia were defined as risk factor conditions. Mean values for a series of risk factor variables were compared between reference subjects (no risk factors) and those with a risk factor condition (either one condition only, or in combination with one or more others). Prevalence estimates for each risk factor condition in combination with three or more other conditions were three to four times greater than expected by chance, and levels of risk factors for subjects with more than one risk factor condition were further away from the reference levels than for those with just one condition. Fasting and 2-h serum insulin levels were elevated for each condition when in combination with others, or to a lesser extent when isolated. However, this was not the case for isolated hypertension where insulin levels were not elevated. When adjusted for age, sex, and body mass index, insulin levels were only significantly elevated in subjects with upper-body obesity if in association with general obesity.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

该研究的目的是调查在毛里求斯的多民族人群中是否存在被称为胰岛素抵抗综合征的心血管疾病危险因素组合,并评估高胰岛素血症是否是该综合征的关键特征。1987年,在一项非传染性疾病调查中对5080名毛里求斯受试者(年龄在25 - 74岁之间)进行了检查。调查程序包括口服葡萄糖耐量试验,以及人体测量、血压、血脂和血清胰岛素测量。葡萄糖耐量异常(糖尿病和糖耐量受损)、全身性肥胖、上身肥胖、高血压、低高密度脂蛋白胆固醇和高甘油三酯血症被定义为危险因素状况。比较了参照受试者(无危险因素)和有危险因素状况的受试者(仅有一种状况,或与一种或多种其他状况组合)之间一系列危险因素变量的平均值。每种危险因素状况与三种或更多其他状况组合的患病率估计值比偶然预期的高3至4倍,并且患有多种危险因素状况的受试者的危险因素水平比仅有一种状况的受试者更远离参照水平。当与其他状况组合时,每种状况的空腹和2小时血清胰岛素水平都会升高,单独存在时升高幅度较小。然而,孤立性高血压并非如此,其胰岛素水平并未升高。在调整年龄、性别和体重指数后,上身肥胖且伴有全身性肥胖的受试者的胰岛素水平才会显著升高。(摘要截断于250字)

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