Lindahl B, Asplund K, Eliasson M
Department of Nutritional Research, University of Umea, Sweden.
Int J Epidemiol. 1996 Apr;25(2):291-9. doi: 10.1093/ije/25.2.291.
Many studies have, in small and highly selected study populations, described how cardiovascular risk factors tend to cluster in subjects with insulin resistance. Recently, interest has focused on possible relationships between this insulin resistance syndrome and fibrinolysis, and the role of triglycerides in this association. The present study addresses these issues in a general population.
A subsample of participants in the population-based Northern Sweden MONICA (MONItoring of trends and determinants in CArdiovascular diseases) Study, consisting of 353 men and 403 women in the 25-64 year age range, was investigated. Insulin resistance was estimated indirectly from the fasting levels of insulin and glucose. Fibrinolytic activity was measured both as plasminogen activator inhibitor type 1 (PAI-1) activity and tissue plasminogen activator ((t)PA) activity.
Insulin resistance was highly correlated with those cardiovascular risk factors that have been associated with the insulin resistance syndrome, and to the measures of fibrinolytic activity. Subjects in the upper tertile of insulin resistance had a PAI-1 activity that was three times higher than that of the lower third men and twice as high in women. There was a strong interaction between insulin resistance and serum triglycerides. Low versus high levels of both variables together were associated with a fivefold difference in PAI-1 activity in men and a threefold difference in women. The (t)PA activity was inversely correlated to both insulin resistance and serum triglycerides.
In a general population, the 'insulin resistance syndrome' is closely associated with low fibrinolytic activity. Serum triglyceride levels interact with insulin resistance to predict fibrinolytic activity.
许多研究在小规模且经过高度筛选的研究人群中描述了心血管危险因素如何倾向于在胰岛素抵抗患者中聚集。最近，人们的兴趣集中在这种胰岛素抵抗综合征与纤维蛋白溶解之间可能存在的关系，以及甘油三酯在这种关联中的作用。本研究在一般人群中探讨了这些问题。
对基于人群的瑞典北部莫尼卡（心血管疾病趋势和决定因素监测）研究中的一个子样本进行了调查，该子样本由353名男性和403名年龄在25至64岁之间的女性组成。通过胰岛素和葡萄糖的空腹水平间接估计胰岛素抵抗。纤维蛋白溶解活性通过1型纤溶酶原激活物抑制剂（PAI-1）活性和组织纤溶酶原激活物（tPA）活性来测量。
胰岛素抵抗与那些与胰岛素抵抗综合征相关的心血管危险因素以及纤维蛋白溶解活性的测量指标高度相关。胰岛素抵抗处于上三分位数的受试者，其PAI-1活性比下三分位数的男性高两倍，女性高两倍。胰岛素抵抗和血清甘油三酯之间存在强烈的相互作用。两个变量的低水平与高水平共同作用，导致男性PAI-1活性相差五倍，女性相差三倍。tPA活性与胰岛素抵抗和血清甘油三酯均呈负相关。
在一般人群中，“胰岛素抵抗综合征”与低纤维蛋白溶解活性密切相关。血清甘油三酯水平与胰岛素抵抗相互作用以预测纤维蛋白溶解活性。
