Burchfiel C M, Curb J D, Arakaki R, Abbott R D, Sharp D S, Rodriguez B L, Yano K
Honolulu Epidemiology Research Unit, National Heart, Lung, and Blood Institute, HI 96817, USA.
Ann Epidemiol. 1996 Nov;6(6):490-7. doi: 10.1016/s1047-2797(96)00103-2.
Associations of cardiovascular risk factors, including several measures of adiposity, with hyperinsulinemia were assessed in 3562 elderly (71 to 93 years of age) Japanese American men from the Honolulu Heart Program who were examined between 1991 and 1993. In addition, cardiovascular risk factors measured 25 years earlier were also examined in relation to hyperinsulinemia. Hyperinsulinemia was defined as fasting insulin > or = 95th percentile (20 microU/mL) among the subset of subjects (n = 504) who were nonobese and free of clinical diabetes and glucose intolerance. When this definition was applied to the entire population, the prevalence of hyperinsulinemia declined cross-sectionally with age (P < 0.001) from 24.2% in men aged 71 to 74 years to 16.4% in men aged 85 to 93 years. Factors having a positive and independent association with hyperinsulinemia included body mass index (BMI), triglycerides, glucose, hematocrit, use of diabetic medication, heart rate, and hypertension. The association with physical activity was negative. Triglycerides, BMI, diabetic medication, hypertension, and smoking levels measured 25 years earlier were also associated independently with hyperinsulinemia. Associations were similar in nondiabetic subjects. Three measures of adiposity (BMI, waist circumference, and subscapular skinfold thickness) were independently related to hyperinsulinemia cross-sectionally. However, associations involving a difference between the 80th and 20th percentiles in each adiposity measure appeared strongest for BMI (odds ratio (OR) = 4.5, 95% confidence interval (CI) = 3.7 to 5.6) and waist circumference (OR = 4.1, 95% CI = 3.3-5.1) and slightly weaker for subscapular skinfold thickness (OR = 2.1, 95% CI = 1.8-2.5). These findings suggest that features of an insulin resistance syndrome including dyslipidemia, glucose intolerance, hypertension, and obesity, assessed both cross-sectionally and 25 years previously, are associated independently with hyperinsulinemia in elderly Japanese American men.
在1991年至1993年间接受检查的3562名来自檀香山心脏项目的日裔美国老年男性（71至93岁）中，评估了包括多种肥胖指标在内的心血管危险因素与高胰岛素血症之间的关联。此外，还研究了25年前测量的心血管危险因素与高胰岛素血症的关系。高胰岛素血症定义为在非肥胖且无临床糖尿病和葡萄糖耐量异常的受试者子集（n = 504）中，空腹胰岛素水平>或=第95百分位数（20微单位/毫升）。当将此定义应用于整个人群时，高胰岛素血症的患病率随年龄呈横断面下降（P < 0.001），从71至74岁男性的24.2%降至85至93岁男性的16.4%。与高胰岛素血症呈正相关且独立相关的因素包括体重指数（BMI）、甘油三酯、血糖、血细胞比容、糖尿病药物使用、心率和高血压。与身体活动的关联为负相关。25年前测量的甘油三酯、BMI、糖尿病药物使用、高血压和吸烟水平也与高胰岛素血症独立相关。在非糖尿病受试者中，关联情况相似。三种肥胖指标（BMI、腰围和肩胛下皮褶厚度）与高胰岛素血症呈横断面独立相关。然而，每种肥胖指标中第80百分位数与第20百分位数之间的差异所涉及的关联，对于BMI（优势比（OR） = 4.5，95%置信区间（CI） = 3.7至5.6）和腰围（OR = 4.1，95% CI = 3.3 - 5.1）似乎最强，而对于肩胛下皮褶厚度则稍弱（OR = 2.1，95% CI = 1.8 - 2.5）。这些发现表明，无论是横断面评估还是25年前评估的胰岛素抵抗综合征特征，包括血脂异常、葡萄糖耐量异常、高血压和肥胖，都与日裔美国老年男性的高胰岛素血症独立相关。
