Colman E, Toth M J, Katzel L I, Fonong T, Gardner A W, Poehlman E T
Department of Medicine, University of Maryland School of Medicine, Baltimore, USA.
Int J Obes Relat Metab Disord. 1995 Nov;19(11):798-803.
Elevated levels of fasting insulin increase the risk for coronary artery disease. In this study, we considered the independent contributions of age, total body fatness, abdominal fat distribution, peak aerobic capacity, leisure time physical activity, dietary intake, and fasting glucose levels to the age-associated increase in fasting insulin levels in healthy men and women.
A cross-sectional analysis.
A total of 427 healthy men and 293 healthy women age 18 to 90 years.
Plasma glucose and insulin levels were measured in the fasted state and subjects were characterized for body fatness from underwater weighting, abdominal fat distribution from the waist circumference, peak VO2 from a treadmill test to exhaustion, leisure time physical activity from a structured interview and dietary intake from a 3-day food diary. The independent predictors of fasting insulin levels were determined by stepwise multiple regression analysis.
Fasting insulin concentrations increased with age in both men (0.09 +/- 0.02 pmol/yr, unadjusted slope +/- SEE) and women (0.14 +/- 0.03 pmol/yr). In men, the major independent predictors of fasting insulin levels were percent body fat (r2 = 28%, P < 0.001) and waist circumference (r2 = 3% P < 0.001). Age, glucose concentration, and peak VO2 were small (1% each), but independent contributors to the variance in insulin levels. In women, the waist circumference (r2 = 18%, P < 0.001) and the fasting glucose concentration (r2 = 7%, P < 0.001) were the independent correlates of fasting insulin concentrations.
Our data suggest that total adiposity and central body fat distribution are significant determinants of the increase in fasting insulin levels, whereas age, dietary intake, and levels of aerobic fitness and physical activity appear to be less important contributors to the variation in fasting insulin concentrations in healthy men and women.
空腹胰岛素水平升高会增加患冠状动脉疾病的风险。在本研究中，我们探讨了年龄、总体脂、腹部脂肪分布、最大有氧能力、休闲时间体力活动、饮食摄入以及空腹血糖水平对健康男性和女性中与年龄相关的空腹胰岛素水平升高的独立影响。
横断面分析。
共427名年龄在18至90岁之间的健康男性和293名健康女性。
在空腹状态下测量血浆葡萄糖和胰岛素水平，通过水下称重法评估体脂情况，用腰围评估腹部脂肪分布，通过跑步机力竭试验测定最大摄氧量（VO₂峰值），通过结构化访谈了解休闲时间体力活动情况，并通过3天食物日记记录饮食摄入。通过逐步多元回归分析确定空腹胰岛素水平的独立预测因素。
男性（0.09±0.02 pmol/年，未调整斜率±标准误）和女性（0.14±0.03 pmol/年）的空腹胰岛素浓度均随年龄增长而升高。在男性中，空腹胰岛素水平的主要独立预测因素是体脂百分比（r² = 28%，P < 0.001）和腰围（r² = 3%，P < 0.001）。年龄、葡萄糖浓度和VO₂峰值对胰岛素水平方差的贡献较小（均为1%），但具有独立性。在女性中，腰围（r² = 18%，P < 0.001）和空腹葡萄糖浓度（r² = 7%，P < 0.001）是空腹胰岛素浓度的独立相关因素。
我们的数据表明，总体肥胖和中心性体脂分布是空腹胰岛素水平升高的重要决定因素，而年龄、饮食摄入、有氧适能和体力活动水平似乎对健康男性和女性空腹胰岛素浓度变化的影响较小。
