Ezenwaka C E, Akanji A O, Unwin N, Alberti K G
Department of Chemical Pathology, University College Hospital, Ibadan, Nigeria.
Diabet Med. 1996 Oct;13(10):874-81. doi: 10.1002/(SICI)1096-9136(199610)13:10<874::AID-DIA244>3.0.CO;2-8.
The aim was to establish whether risk factors for cardiovascular disease (CVD) are positively and independently associated with fasting insulin and/or body mass and waist-hip ratio in healthy elderly Nigerian subjects. Fasting plasma glucose, insulin, total cholesterol, triglycerides, blood pressure, and basal insulin resistance (HOMA method) were measured in 500 healthy elderly (> or = 55 years) Nigerian volunteers (295 men, 205 women). Associations between blood pressure, triglycerides or cholesterol and fasting insulin, HOMA, body mass index (BMI) or waist-hip ratio were examined using linear regression. Age was controlled for in all analyses. In men, diastolic and systolic blood pressure were strongly associated with BMI, while there was no evidence of an independent relationship with fasting insulin or HOMA. Triglycerides were strongly associated with waist-hip ratio, with a weaker independent association with HOMA but not fasting insulin; fasting insulin and HOMA showed strong independent associations with total cholesterol. In women diastolic and systolic blood pressure were also strongly associated with BMI, but there was an independent relationship with fasting insulin for diastolic blood pressure and a less significant (p = 0.057) one for systolic blood pressure. Triglycerides were significantly associated with BMI but none of the other variables; there were no significant associations with cholesterol. There was no evidence of interaction between fasting insulin or HOMA and BMI or waist-hip ratio. The results suggest the hypotheses that in this population BMI or waist-hip ratio are stronger determinants of blood pressure and triglyceride levels than fasting insulin or HOMA, and that where insulin does play a role its effects are separate and additive.
目的是确定心血管疾病（CVD）的危险因素是否与健康的尼日利亚老年受试者的空腹胰岛素和/或体重及腰臀比呈正相关且独立相关。对500名年龄≥55岁的健康尼日利亚志愿者（295名男性，205名女性）测量了空腹血糖、胰岛素、总胆固醇、甘油三酯、血压和基础胰岛素抵抗（HOMA法）。使用线性回归分析血压、甘油三酯或胆固醇与空腹胰岛素、HOMA、体重指数（BMI）或腰臀比之间的关联。所有分析均对年龄进行了控制。在男性中，舒张压和收缩压与BMI密切相关，而没有证据表明与空腹胰岛素或HOMA存在独立关系。甘油三酯与腰臀比密切相关，与HOMA的独立关联较弱，但与空腹胰岛素无关；空腹胰岛素和HOMA与总胆固醇呈强独立关联。在女性中，舒张压和收缩压也与BMI密切相关，但舒张压与空腹胰岛素存在独立关系，收缩压的独立关系则不太显著（p = 0.057）。甘油三酯与BMI显著相关，但与其他变量均无显著关联；与胆固醇也无显著关联。没有证据表明空腹胰岛素或HOMA与BMI或腰臀比之间存在相互作用。结果提示以下假设：在该人群中，BMI或腰臀比是血压和甘油三酯水平比空腹胰岛素或HOMA更强的决定因素，并且胰岛素发挥作用时其效应是独立且相加的。
