胰岛素耐药性和充血性心力衰竭的风险
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
概括
胰岛素抵抗预示着老年男性的充血性心力衰竭 (CHF),独立于糖尿病. 肥胖问题 肥胖问题
科学领域:
- 心脏病学 心脏病学
- 代谢综合征是代谢综合征的一种.
- 流行病学 流行病学
背景情况:
- 糖尿病和肥胖是已知的充血性心力衰竭 (CHF) 的危险因素.
- 这两种情况都与胰岛素抵抗有关,胰岛素抵抗是一种关键的代谢功能障碍.
研究的目的:
- 调查胰岛素抵抗是否可以预测心血管衰竭的发病率.
- 确定胰岛素抵抗是否调解肥胖和心血管疾病之间的关系.
主要方法:
- 对1187名老年男性进行的前性,基于社区的观察性研究 (Uppsala成年男性纵向研究).
- 分析胰岛素敏感性 (euglycemic胰岛素的葡萄糖处理率) 和肥胖的标志物.
- 考克斯比例危险模型用于评估CHF发病率预测指标,平均随访时间为8.9年.
主要成果:
- 与更高的2小时葡萄糖和禁食前胰岛素水平相关的CHF风险增加,表明胰岛素耐药性.
- 肥胖指标 (BMI,腰围) 也预测了CHF.
- 改善的胰岛素敏感性 (更高的葡萄糖排放率) 与降低心血管疾病风险有关.
结论:
- 胰岛素抵抗独立地预测了老年男性的心血管疾病发病率,甚至超出了糖尿病等已知的危险因素.
- 肥胖和CHF之间的关联似乎在很大程度上是由潜在的胰岛素耐药性介导的.
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