Asplund-Carlson A
King Gustaf V Research Institute, Karolinska Hospital, Stockholm, Sweden.
Eur J Clin Invest. 1995 Oct;25(10):769-76. doi: 10.1111/j.1365-2362.1995.tb01956.x.
Hypertriglyceridaemia, insulin resistance and glucose intolerance are conditions associated with an increased risk of coronary heart disease. In this study we have examined randomly selected nondiabetic hypertriglyceridaemic (HTG) males, 40-50 years (n = 65) and age-matched normotriglyceridaemic (NTG) controls (n = 61). The (mean +/- SD) insulin sensitivity index, as assessed by the Minimal Model method, was significantly lower in the HTG compared with the NTG group (3.69 +/- 2.96 vs. 6.29 +/- 3.38 x 10(-4) min-1 per mUL-1; P < 0.001). Thirty-eight per cent of the HTG group was glucose intolerant, compared with 8% in the NTG group (X2 = 13.16; P < 0.001). The glucose intolerant HTG sub-group had, when compared with the glucose tolerant one, significantly higher serum concentrations of apoB (1318 +/- 284 vs. 1094 +/- 312 mg L-1; P < 0.01) and glycerol (84 +/- 26 vs. 65 +/- 22 nmol L-1; P < 0.01). Serum FFA concentrations were, irrespective of glucose tolerance/intolerance, higher in the HTG than in the NTG group. By logistic regression analysis with the HTG/NTG state as the dichotomous variable, it was found that neither a low insulin sensitivity, nor glucose intolerance were independently linked with the HTG state. Instead, the lower insulin sensitivity of the HTG group was related to their higher body mass index. The higher frequency of glucose intolerance in the HTG group was explained by their higher mean serum apoB concentration, when compared with the NTG group. In conclusion, this study of a randomly selected of HTG group has confirmed the frequent coexistance of HTG, insulin resistance and glucose intolerance. The new important finding was that neither of these two latter conditions appear to be of direct pathogenetic importance for HTG.
高甘油三酯血症、胰岛素抵抗和葡萄糖耐量异常均与冠心病风险增加相关。在本研究中,我们随机选取了年龄在40至50岁之间的非糖尿病高甘油三酯血症(HTG)男性(n = 65)以及年龄匹配的正常甘油三酯血症(NTG)对照者(n = 61)。通过最小模型法评估的胰岛素敏感性指数(均值±标准差),HTG组显著低于NTG组(3.69±2.96 vs. 6.29±3.38×10⁻⁴ min⁻¹ per mU L⁻¹;P < 0.001)。HTG组中38%存在葡萄糖耐量异常,而NTG组为8%(X² = 13.16;P < 0.001)。与葡萄糖耐量正常的HTG亚组相比,葡萄糖耐量异常的HTG亚组血清载脂蛋白B(apoB)浓度(1318±284 vs. 1094±312 mg L⁻¹;P < 0.01)和甘油浓度(84±26 vs. 65±22 nmol L⁻¹;P < 0.01)显著更高。无论葡萄糖耐量情况如何,HTG组血清游离脂肪酸(FFA)浓度均高于NTG组。以HTG/NTG状态作为二分变量进行逻辑回归分析发现,低胰岛素敏感性和葡萄糖耐量异常均与HTG状态无独立关联。相反,HTG组较低的胰岛素敏感性与其较高的体重指数有关。与NTG组相比,HTG组较高的平均血清apoB浓度解释了其较高的葡萄糖耐量异常发生率。总之,这项对随机选取的HTG组的研究证实了HTG、胰岛素抵抗和葡萄糖耐量异常常同时存在。新的重要发现是,后两种情况似乎对HTG均无直接致病重要性。