Raitakari O T, Porkka K V, Rönnemaa T, Knip M, Uhari M, Akerblom H K, Viikari J S
Cardiorespiratory Research Unit, University of Turku, Finland.
Diabetologia. 1995 Sep;38(9):1042-50. doi: 10.1007/BF00402173.
In adults hyperinsulinaemia is associated with an atherogenic risk profile including obesity, low levels of HDL-cholesterol, high levels of triglycerides and elevated blood pressure. To examine these associations in the young we studied the cross-sectional relationships of insulin with obesity indices (body mass index, subscapular skinfold thickness), serum lipids and blood pressure in 1,865 children, adolescents and young adults aged 6-24 years. We also used longitudinal data to study the value of a single insulin measurement to predict high risk factor levels and clustering of multiple risk factors after a 6-year follow-up. In cross-sectional analyses the levels of triglycerides, HDL-cholesterol, systolic blood pressure and obesity indices were usually significantly different across the quartiles of fasting insulin in both sexes among children, adolescents and young adults. In general, no associations were seen with total cholesterol or LDL-cholesterol. In prospective analysis elevated baseline insulin was related to the incidence of hypertriglyceridaemia (> or = 95th percentile) at the follow-up. This relationship persisted even after adjustments for baseline obesity or 6-year change in obesity status. Moreover, baseline insulin concentration was higher in subjects who subsequently showed clustering of high triglycerides, low HDL-cholesterol and high systolic blood pressure levels at the follow-up. We conclude that high fasting insulin levels measured in children and adolescents predict the development of hypertriglyceridaemia years later. In addition, high insulin levels seem to precede the development of a potentially atherogenic risk factor profile including low HDL-cholesterol, high triglycerides and high systolic blood pressure.
在成年人中，高胰岛素血症与致动脉粥样硬化风险谱相关，包括肥胖、低水平的高密度脂蛋白胆固醇、高水平的甘油三酯和血压升高。为了研究年轻人中的这些关联，我们在1865名6至24岁的儿童、青少年和年轻人中，研究了胰岛素与肥胖指数（体重指数、肩胛下皮褶厚度）、血脂和血压之间的横断面关系。我们还使用纵向数据来研究单次胰岛素测量对于预测6年随访后高风险因素水平及多种风险因素聚集情况的价值。在横断面分析中，儿童、青少年和年轻人中，无论男女，甘油三酯、高密度脂蛋白胆固醇、收缩压水平和肥胖指数在空腹胰岛素四分位数间通常存在显著差异。一般而言，未发现与总胆固醇或低密度脂蛋白胆固醇有关联。在前瞻性分析中，基线胰岛素升高与随访时高甘油三酯血症（≥第95百分位数）的发生率相关。即使在对基线肥胖或肥胖状态的6年变化进行调整后，这种关系仍然存在。此外，在随访时出现高甘油三酯、低高密度脂蛋白胆固醇和高收缩压水平聚集的受试者，其基线胰岛素浓度更高。我们得出结论，在儿童和青少年中测得的高空腹胰岛素水平可预测数年后高甘油三酯血症的发生。此外，高胰岛素水平似乎先于包括低高密度脂蛋白胆固醇、高甘油三酯和高收缩压在内的潜在致动脉粥样硬化风险因素谱的出现。
