Lazarus R, Sparrow D, Weiss S T
Dept of Public Health and Community Medicine, Faculty of Medicine, University of Sydney, Australia.
Eur Respir J. 1998 Sep;12(3):635-40. doi: 10.1183/09031936.98.12030635.
Lower levels of baseline ventilatory function have consistently been associated with increased risk of cardiovascular mortality in prospective studies, but the underlying mechanisms are not known. Increased risk of coronary heart disease is associated with higher serum insulin levels. This report examines the relationship between ventilatory function and indirect measures of insulin resistance. Cross-sectional data from 922 nondiabetic participants in the Normative Aging Study were analysed using multiple linear regression models with adjustment for potential confounders. Forced vital capacity (FVC) and forced expiratory volume in one second (FEV1) were examined in relation to indicators of insulin resistance, i.e. fasting insulin and the fasting insulin resistance index (FIRI). Diabetics were excluded because impaired insulin secretion interferes with the validity of these as measures of insulin resistance. Fasting insulin and FIRI were negatively correlated with FVC and FEV1 (all p< 0.001). These associations persisted after adjusting for potential confounders including age, height, body mass index, waist to hip circumference ratio, physical activity, alcohol intake and smoking in separate multiple linear regression models, for both insulin (all p< or =0.0008) and FIRI (all p< or =0.0001). Negative cross-sectional associations between ventilatory function and indirect measures of insulin resistance were found in nondiabetic males. Insulin resistance may contribute to the previously unexplained association between ventilatory function impairment and cardiovascular mortality. Mechanisms underlying the relationship between insulin resistance and decreased ventilatory function remain to be elucidated.
在前瞻性研究中，较低的基线通气功能水平一直与心血管疾病死亡率增加相关，但潜在机制尚不清楚。冠心病风险增加与较高的血清胰岛素水平有关。本报告探讨了通气功能与胰岛素抵抗间接指标之间的关系。使用多元线性回归模型对来自规范衰老研究的922名非糖尿病参与者的横断面数据进行分析，并对潜在混杂因素进行调整。研究了用力肺活量（FVC）和一秒用力呼气量（FEV1）与胰岛素抵抗指标，即空腹胰岛素和空腹胰岛素抵抗指数（FIRI）之间的关系。排除糖尿病患者，因为胰岛素分泌受损会干扰这些指标作为胰岛素抵抗测量的有效性。空腹胰岛素和FIRI与FVC和FEV1呈负相关（所有p<0.001）。在单独的多元线性回归模型中，对包括年龄、身高、体重指数、腰臀比、身体活动、酒精摄入量和吸烟在内的潜在混杂因素进行调整后，胰岛素（所有p≤0.0008）和FIRI（所有p≤0.0001）的这些关联仍然存在。在非糖尿病男性中发现通气功能与胰岛素抵抗间接指标之间存在负向横断面关联。胰岛素抵抗可能导致通气功能损害与心血管疾病死亡率之间先前无法解释的关联。胰岛素抵抗与通气功能下降之间关系的潜在机制仍有待阐明。
