Inflammation and insulin resistance are independently related to all-cause of death and cardiovascular events in Japanese patients with type 2 diabetes mellitus
Inflammation and insulin resistance are independently related to all-cause of death and cardiovascular events in Japanese patients with type 2 diabetes mellitus
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DOI：
10.1016/s0021-9150(03)00198-9
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发表时间：
2003-08-01
期刊：
影响因子：
5.3
通讯作者：
Miyake, S
中科院分区：
文献类型：
--
作者：
Matsumoto, K;Sera, Y;Miyake, S
胰岛素抵抗(IR)/高胰岛素血症和低度炎症(高敏C反应蛋白[hs-CRP])可以预测心血管疾病。然而，由于IR和炎症(IF)尚未被同时评估，尚不清楚IR和IF是否与心血管疾病独立相关。此外，IR和IF在预测心血管疾病方面的联合作用目前尚不清楚。因此，我们测量了350名日本2型糖尿病患者的胰岛素敏感性(胰岛素耐量试验的K指数；KITT)和hs-CRP，并对他们进行了1-7年(平均4.5年)的跟踪调查。在随访期间，33名患者死亡，53名患者发展为非致命性冠状动脉疾病或中风(终点)。年龄、收缩压、吸烟史、既往心血管病史、KITT和hs-CRP独立地与终点显著相关。1-S.D.差异与KITT(1.45；95%CI 1.09-1.91)和hs-CRP(1.30；1.04-1.67)的相对风险显著增加相关。当患者细分为三分体时，KITT最高三分体的相对危险度为1.76(95%CI为1.01~3.11)，hs-CRP为2.00(1.03~3.85)。KITT和hs-CRP中最高三分位数的相对危险度为5.32(1.18-24.0)，而这两个值中最低三位数的相对危险度为5.32(1.18-24.0)。总而言之，在日本2型糖尿病患者中，低级别IF和IR与全死因和心血管疾病独立相关。低等级中频和红外的共存放大了这一效应。(C)2003爱思唯尔爱尔兰有限公司。保留所有权利。
Insulin resistance (IR)/hyperinsulinemia and low-grade inflammation (high-sensitivity C-reactive protein [hs-CRP]) can predict cardiovascular disease. However, because IR and inflammation (IF) have not been evaluated simultaneously, it is not known whether IR and IF are independently related to cardiovascular disease. Furthermore, the combined effect of IR and IF on the prediction of cardiovascular disease is presently unknown. Thus, we measured insulin sensitivity (K index of the insulin tolerance test; KITT) and hs-CRP in 350 Japanese patients with type 2 diabetes, and followed them for 1-7 years (mean, 4.5 years). During the follow-up, 33 patients died and 53 patients developed non-fatal coronary artery disease or stroke (endpoint). Age, systolic blood pressure, current smoking, past history of cardiovascular disease, KITT, and hs-CRP independently and significantly correlated with endpoint. One-S.D. difference was associated with a significant increase of relative risk in KITT (1.45; 95% CI 1.09-1.91) and hs-CRP (1.30; 1.04-1.67). When patients were subdivided to tertile, the relative risk in the highest tertile of KITT was 1.76 (95% CI 1.01-3.11) and hs-CRP was 2.00 (1.03-3.85) compared with the patients with lowest tertile. The relative risk in the highest tertile of both KITT and hs-CRP was 5.32 (1.18-24.0) compared with the lowest tertile of both values. In conclusion, low-grade IF and IR are independently related to all-cause of death and cardiovascular disease in Japanese patients with type 2 diabetes. Coexistence of low-grade IF and IR amplify this effect. (C) 2003 Elsevier Ireland Ltd. All rights reserved.