Barrett-Connor E, Schrott H G, Greendale G, Kritz-Silverstein D, Espeland M A, Stern M P, Bush T, Perlman J A
Department of Family and Preventive Medicine, University of California, San Diego, La Jolla 92093-0607, USA.
Diabetes Care. 1996 Apr;19(4):333-40. doi: 10.2337/diacare.19.4.333.
Little is known about the covariates of hyperglycemia and hyperinsulinemia. We examined candidate factors in postmenopausal women.
We determined the cross-sectional associations of sociodemographic, body-size, lifestyle, reproductive, and menopausal factors with pretrial fasting and postchallenge glucose and insulin levels in 869 postmenopausal women aged 45-65 years. Women were participants in the Postmenopausal Estrogen/Progestin Interventions study who were not taking estrogen or insulin.
Plasma glucose levels increased significantly with age; serum insulin levels did not. BMI and waist-to-hip ratio (WHR) each showed graded positive and independent associations with glucose and insulin levels. Alcohol intake, cigarette smoking, physical activity, parity, education, and income were also associated with insulin or glucose in age-adjusted models. In multivariable models, BMI and WHR explained 18% of the variability in fasting glucose, 16% in postchallenge glucose, 28% in fasting insulin, and 17% in postchallenge insulin. Age and all other factors combined accounted for < 6% of the variance in glucose or insulin. In multiply adjusted models, African-American and Hispanic women had higher fasting and 2-h insulin levels than non-Hispanic white women.
Most of the variance in glycemia and insulin is unexplained. Measures of obesity and fat distribution account for nearly all the explained variance.
关于高血糖和高胰岛素血症的协变量了解甚少。我们研究了绝经后女性中的候选因素。
我们确定了869名年龄在45至65岁之间的绝经后女性的社会人口统计学、体型、生活方式、生殖和绝经因素与试验前空腹及激发后血糖和胰岛素水平之间的横断面关联。这些女性是绝经后雌激素/孕激素干预研究的参与者，且未服用雌激素或胰岛素。
血浆葡萄糖水平随年龄显著升高；血清胰岛素水平则不然。体重指数（BMI）和腰臀比（WHR）均与葡萄糖和胰岛素水平呈分级正相关且相互独立。在年龄调整模型中，饮酒、吸烟、身体活动、产次、教育程度和收入也与胰岛素或葡萄糖有关。在多变量模型中，BMI和WHR分别解释了空腹血糖变异性的18%、激发后血糖变异性的16%、空腹胰岛素变异性的28%和激发后胰岛素变异性的17%。年龄和所有其他因素综合起来占葡萄糖或胰岛素变异性的比例小于6%。在多重调整模型中，非裔美国女性和西班牙裔女性的空腹及2小时胰岛素水平高于非西班牙裔白人女性。
血糖和胰岛素的大部分变异性无法解释。肥胖和脂肪分布的测量指标几乎解释了所有已解释的变异性。
