Singh R B, Rastogi S S, Niaz M A, Postiglione A
Heart Research Laboratory, Medical Hospital and Research Centre, Moradabad, India.
Coron Artery Dis. 1998;9(9):559-65. doi: 10.1097/00019501-199809090-00002.
To test the hypothesis that high prevalences of cardiovascular disease and diabetes in urban population of India are manifestations of insulin-resistance syndrome.
Cross-sectional surveys were conducted in 20 streets in the city of Moradabad and in two villages.
There were 566 subjects (255 rural and 311 urban) aged 60-84 years. All subjects were divided on the basis of their insensitivity to insulin into groups with mild, moderate and high insensitivity to insulin and data from both sexes were pooled for analysis.
Overall increases in the prevalences of coronary disease, diabetes, hypertension, central obesity and associated disturbances were observed with increasing insensitivity to insulin and the trend was more significant among urban than it was among rural subjects. Multivariate logistic regression analysis revealed a significant positive association of level of insulin insensitivity with the age-adjusted prevalences of coronary disease, hypertension, diabetes, hypertriglyceridaemia, intolerance of glucose and central obesity among urban subjects. We observed a significant inverse association between insensitivity to insulin and physical activity both for rural and for urban subjects and between insensitivity to insulin and high-density lipoprotein cholesterol level for urban subjects. For rural subjects, we found significant associations of sensitivity to insulin with coronary artery disease and intolerance of glucose without significant associations with other risk factors.
Insensitivity to insulin was significantly associated with risks of cardiovascular disease and diabetes, despite there being a low prevalence of obesity (9.0%) among urban subjects. Hypertension, diabetes, hypertriglyceridaemia, intolerance of glucose and central obesity were significantly associated with insensitivity to insulin and coronary disease for urban but not for rural people.
检验印度城市人口中心血管疾病和糖尿病的高患病率是胰岛素抵抗综合征表现这一假设。
在莫拉达巴德市的20条街道和两个村庄进行横断面调查。
共有566名年龄在60 - 84岁的受试者（255名农村受试者和311名城市受试者）。所有受试者根据其对胰岛素的不敏感性分为对胰岛素轻度、中度和高度不敏感组，将男女数据合并进行分析。
随着对胰岛素不敏感性增加，冠心病、糖尿病、高血压、中心性肥胖及相关紊乱的患病率总体上升，且城市受试者中的这一趋势比农村受试者更为显著。多因素逻辑回归分析显示，城市受试者中胰岛素不敏感水平与年龄调整后的冠心病、高血压、糖尿病、高甘油三酯血症、葡萄糖不耐受及中心性肥胖患病率呈显著正相关。我们观察到，农村和城市受试者中胰岛素不敏感性与体力活动之间均存在显著负相关，城市受试者中胰岛素不敏感性与高密度脂蛋白胆固醇水平之间也存在显著负相关。对于农村受试者，我们发现胰岛素敏感性与冠状动脉疾病及葡萄糖不耐受显著相关，与其他危险因素无显著关联。
尽管城市受试者中肥胖患病率较低（9.0%），但胰岛素不敏感性与心血管疾病和糖尿病风险显著相关。高血压、糖尿病、高甘油三酯血症、葡萄糖不耐受及中心性肥胖与城市人群而非农村人群的胰岛素不敏感性及冠心病显著相关。
