インスリン抵抗性と閉塞性心不全のリスク
Erik Ingelsson1, Johan Sundström, Johan Arnlöv
1Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden. erik.ingelsson@pubcare.uu.se
JAMA
|July 21, 2005
まとめ
インスリン抵抗性は,糖尿病とは関係なく,高齢の男性における閉塞性心不全 (CHF) を予測します. 肥満 肥満について
科学分野:
- 心臓病学 心臓病学
- メタボリックシンドロームとは
- エピデミオロジー エピデミオロジー
背景:
- 糖尿病と肥満は,充血性心不全 (CHF) の危険因子として知られています.
- 両方の症状は,重要な代謝機能障害であるインスリン抵抗性に関連しています.
研究 の 目的:
- インスリン抵抗性のCHFの発生率を予測できるかどうかを調査する.
- インスリン抵抗性が肥満とCHFの関係を媒介するかどうかを判断する.
主な方法:
- 1187人の高齢者男性を対象とした前向きな,コミュニティベースの観察研究 (Uppsala 長距離研究).
- インスリン感受性 (euglycemic insulin clamp glucose disposal rate) と肥満マーカーの分析 インスリン感受性 (euglycemic insulin clamp glucose disposal rate) と肥満マーカーの分析 インスリン感受性 (euglycemic insulin clamp glucose disposal rate) と肥満マーカーの分析 インスリン感受性 (euglycemic insulin clamp glucose disposal rate) と肥満マーカーの分析 インスリン感受性の分析
- コックス比例リスクモデルは,CHFの発生率の予測要因を平均8.9年の追跡期間で評価するために使用されました.
主要な成果:
- CHFのリスクの増加は,2時間のグルコースと断食中のプロインスリン濃度の上昇と関連しており,インスリン抵抗性を示しています.
- 肥満マーカー (BMI,腰周) もCHFを予測した.
- インスリン感受性の改善 (クランプ・グルコースの排出率の上昇) は,心臓発作のリスクの低下と関連していました.
結論:
- インスリン抵抗性は,糖尿病のような既定の危険因子を超えて,高齢の男性におけるCHFの発生率を独立して予測します.
- 肥満とCHFの関連性は,主にインスリン抵抗性の基礎によって媒介されているようです.
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