Clausen J O, Hein H O, Suadicani P, Winther K, Gyntelberg F, Pedersen O
Medical Department C, Glostrup Hospital, Copenhagen, Denmark.
Am J Hypertens. 1995 Nov;8(11):1060-6. doi: 10.1016/0895-7061(95)00247-M.
An increased risk of ischemic heart disease in men with the Lewis blood group phenotype Le(a-b-) has been reported. It has been suggested that the Le(a-b-) phenotype is a genetic marker of the insulin resistance syndrome. To examine whether Le(a-b-) confers the insulin resistance syndrome, we studied a random sample of unrelated healthy young white men and women living in Copenhagen (n = 380, 18 to 32 years). All individuals had their insulin sensitivity estimated using Bergman's minimal model (intravenous glucose in combination with tolbutamide) and systolic blood pressure (SBP) was measured with a London School of Hygiene Sphygmomanometer. A number of anthropometric measurements including body mass index (BMI, kilograms/meters squared) and biochemical characteristics were performed. The Lewis blood group typing was carried out on erythrocytes. Twenty-one men had the Le(a-b-) phenotype. Compared to all other men (N = 165), the Le(a-b-) men had a significantly higher SBP (6 mm Hg, P = .0024). They also had higher values of BMI (8%, P = .016), total body fat mass (25%, P = .015), fasting values of serum insulin (32%, P = .006), serum C-peptide (20%, P = .029), and plasma glucose (8%, P = .003). The fasting values of serum lipids, plasminogen activator inhibitor (PAI-1) activity, tissue plasminogen activator (t-PA) antigen, and insulin sensitivity did not differ between Le(a-b-) men and men with other Lewis phenotypes. Altogether 194 women participated in the study of which 21 women had the Le(a-b-) phenotype. Except for a lower PAI-1 activity (45%, P = .044), no values differed between Le(a-b-) women and women with other Lewis phenotypes. The women were also stratified according to use of oral contraceptives. Le(a-b-) women using oral contraceptives (N = 8) had a significantly lower plasma level of fasting PAI-1 activity (P = .029) and t-PA antigen (P = .004) compared to women using oral contraceptives without the Le(a-b-) phenotype (N = 42). Our data support the hypothesis that Le(a-b-) men exhibit features of the insulin resistance syndrome, including higher levels of BMI, SBP, and fasting levels of serum insulin and plasma glucose. In young women no signs of the insulin resistance syndrome were found in subjects with the Le(a-b-) phenotype.
据报道，具有Lewis血型Le(a - b -)表型的男性患缺血性心脏病的风险增加。有人提出，Le(a - b -)表型是胰岛素抵抗综合征的遗传标志物。为了研究Le(a - b -)是否与胰岛素抵抗综合征相关，我们对居住在哥本哈根的无亲属关系的健康年轻白人男性和女性进行了随机抽样研究（n = 380，年龄18至32岁）。所有个体均使用伯格曼最小模型（静脉注射葡萄糖联合甲苯磺丁脲）评估胰岛素敏感性，并用伦敦卫生学院血压计测量收缩压（SBP）。进行了多项人体测量，包括体重指数（BMI，千克/米²）和生化特征检测。对红细胞进行Lewis血型分型。21名男性具有Le(a - b -)表型。与所有其他男性（N = 165）相比，Le(a - b -)男性的SBP显著更高（高6 mmHg，P = .0024）。他们的BMI值也更高（高8%，P = .016），全身脂肪量更高（高25%，P = .015），空腹血清胰岛素值更高（高32%，P = .006），血清C肽值更高（高20%，P = .029），血浆葡萄糖值更高（高8%，P = .003）。Le(a - b -)男性与其他Lewis表型男性的空腹血脂、纤溶酶原激活物抑制剂（PAI - 1）活性、组织纤溶酶原激活物（t - PA）抗原和胰岛素敏感性值无差异。共有194名女性参与研究，其中21名女性具有Le(a - b -)表型。除PAI - 1活性较低（低45%，P = .044）外，Le(a - b -)女性与其他Lewis表型女性的各项值无差异。女性还根据口服避孕药的使用情况进行了分层。与不具有Le(a - b -)表型的口服避孕药女性（N = 42）相比，具有Le(a - b -)表型的口服避孕药女性（N = 8）的空腹血浆PAI - 1活性（P = .029）和t - PA抗原（P = .004）水平显著更低。我们的数据支持以下假设：Le(a - b -)男性表现出胰岛素抵抗综合征的特征，包括较高的BMI、SBP以及空腹血清胰岛素和血浆葡萄糖水平。在年轻女性中，未发现具有Le(a - b -)表型的受试者有胰岛素抵抗综合征的迹象。
