González Villalpando C, Stern M P, Haffner S, Arredondo Pérez B, Martínez Diaz S, Islas Andrade S
Centro de Estudios en Diabetes, American British Cowdray Hospital, México, D.F.
Arch Med Res. 1995;26 Spec No:S9-15.
The insulin resistance syndrome (IRS) is recognized as a harbinger of serious morbidity and high mortality. No published data on the prevalence of the IRS in the Mexican population exist. We estimated the prevalence of the IRS in an area that had 15,532 inhabitants, 3505 (22.6%) of whom were eligible (35-64 years of age, men and non-pregnant women). Interviews were obtained on 2810 (80.2%), a physical and laboratory examination with oral glucose tolerance test, insulin determinations and lipid profile was performed on 2282 individuals, 81.2% of those interviewed, 65.1% of eligibles. The IRS was defined as the coexistence of the triad: hypertension, glucose intolerance (diabetes or impaired glucose tolerance) and dyslipidemia (triglycerides > or = 200 mg/dl and HDL < 35 mg/dl). Using this diagnostic criteria the prevalence of IRS in the general population was 2.97% for men and 3.21% for women. In subjects with impaired glucose tolerance (IGT), the IRS was identified in 11.7%. In diabetics, IRS occurred in 13.7%. Subjects with IRS (IGT and diabetics) were significantly more obese (BMI 30 +/- 4.3 vs. 28.4 +/- 4.2 kg/m2 p < 0.001), had central upper body fat pattern distribution (sub/tri skinfolds 1.66 +/- 1.1 vs. 1.5 +/- 0.7 p < 0.02), (waist/hip circumferences 1 +/- 0.07 vs. 0.97 +/- 0.07 p < 0.001) and hyperinsulinemia fasting and post glucose load (25 +/- 17 vs. 15 +/- 13 p < 0.001, 157 +/- 92 vs. 85 +/- 72 p < 0.001, respectively). We conclude that the prevalence of IRS is high, individuals with IRS in Mexico have an anthropometric profile characterized by central, upper body obesity. A significant proportion of the patients with IGT and DM are at the highest cardiovascular risk.
胰岛素抵抗综合征（IRS）被认为是严重发病和高死亡率的先兆。目前尚无关于墨西哥人群中IRS患病率的公开数据。我们对一个有15532名居民的地区进行了IRS患病率估算，其中3505人（22.6%）符合条件（年龄35 - 64岁，男性及非妊娠女性）。共对2810人（80.2%）进行了访谈，对其中2282人（占受访人数的81.2%，符合条件人数的65.1%）进行了体格检查、实验室检查以及口服葡萄糖耐量试验、胰岛素测定和血脂检测。IRS被定义为以下三联征并存：高血压、糖耐量异常（糖尿病或糖耐量受损）和血脂异常（甘油三酯≥200mg/dl且高密度脂蛋白＜35mg/dl）。采用此诊断标准，一般人群中男性IRS患病率为2.97%，女性为3.21%。在糖耐量受损（IGT）患者中，IRS患病率为11.7%。在糖尿病患者中，IRS患病率为13.7%。患有IRS（IGT和糖尿病患者）的受试者明显更肥胖（体重指数分别为30±4.3 vs. 28.4±4.2kg/m²，p＜0.001），具有上身中心性脂肪分布模式（肩胛下/三头肌皮褶厚度分别为1.66±1.1 vs. 1.5±0.7，p＜0.02），（腰臀围比值分别为1±0.07 vs. 0.97±0.07，p＜0.001），且空腹及葡萄糖负荷后存在高胰岛素血症（分别为25±17 vs. 15±13，p＜0.001；157±92 vs. 85±72，p＜0.001）。我们得出结论，IRS患病率较高，墨西哥患有IRS的个体具有以上身中心性肥胖为特征的人体测量学特征。相当一部分IGT和糖尿病患者处于最高心血管风险水平。
