Risk factor clustering in the insulin resistance syndrome. The Strong Heart Study.
Risk factor clustering in the insulin resistance syndrome. The Strong Heart Study.
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DOI：
10.1093/oxfordjournals.aje.a009712
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发表时间：
1998-11
影响因子：
5
通讯作者：
R. Gray;R. Fabsitz;Linda D. Cowan;Elisa T. Lee;Barbara V. Howard;Peter J. Savage
中科院分区：
文献类型：
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作者：
R. Gray;R. Fabsitz;Linda D. Cowan;Elisa T. Lee;Barbara V. Howard;Peter J. Savage
本研究的目的是检查胰岛素抵抗综合征的主要组成部分如何相互关联，以及与美洲印第安人强心脏研究中的大血管疾病的关系。研究队列（4,228名45-74岁的部落居民）于1989年7月至1992年1月在亚利桑那州、俄克拉荷马州、北达科他州和南达科他州三个中心接受了个人访谈和体格检查；抽取血样，进行75 g口服葡萄糖耐量试验。因子分析用于评估胰岛素抵抗综合征变量组的聚类和相互依赖性。在糖尿病和非糖尿病组中，出现了三个因素。在非糖尿病参与者中，葡萄糖、体重指数和胰岛素在所有考虑的变量中占总方差的35%（男性）和32%（女性），收缩压和舒张压在男性和女性中分别占25%和22%。这两种群集都与冠心病呈正相关，但与周围血管疾病无关。在糖尿病参与者中，收缩压和舒张压的结合是最重要的因素，但聚类与冠心病或周围血管疾病无关。一种含有高密度脂蛋白胆固醇、甘油三酯和葡萄糖的成分与糖尿病女性冠心病和两性外周血管疾病呈正相关。危险因素集群的关联及其与冠心病的关系为理解与胰岛素抵抗和糖尿病相关的代谢紊乱提供了重要线索。
The objective of this study was to examine how the major components of the insulin resistance syndrome relate to each other and to macrovascular disease in American Indians in the Strong Heart Study. The study cohort (4,228 resident tribal members 45-74 years old) underwent a personal interview and a physical examination between July 1989 and January 1992 at three centers: Arizona, Oklahoma, and North and South Dakota; blood samples were drawn and a 75-g oral glucose tolerance test was performed. Factor analysis was used to assess the clustering and interdependence of groups of insulin resistance syndrome variables. Within both diabetic and nondiabetic groups, three factors emerged. In nondiabetic participants, a cluster of glucose, body mass index, and insulin accounted for 35% (male) and 32% (female) of the total variance in all variables considered, and a cluster of systolic blood pressure and diastolic blood pressure accounted for 25% and 22% in men and women, respectively. Both clusters were positively associated with coronary heart disease but not peripheral vascular disease. In diabetic participants, the combination of systolic and diastolic blood pressures was the most important factor, but the cluster was not associated with coronary heart disease or peripheral vascular disease. A component containing high density lipoprotein cholesterol, triglycerides, and glucose had a positive association with coronary heart disease in diabetic women and with peripheral vascular disease in both sexes. The association of clusters of risk factors and their relations with coronary heart disease provide important clues that may be used in understanding the metabolic disorders associated with insulin resistance and diabetes.