INCREASED LEVEL OF HEMOGLOBIN A(1C), BUT NOT IMPAIRED INSULIN SENSITIVITY, FOUND IN HYPERTENSIVE AND NORMOTENSIVE SMOKERS
INCREASED LEVEL OF HEMOGLOBIN A(1C), BUT NOT IMPAIRED INSULIN SENSITIVITY, FOUND IN HYPERTENSIVE AND NORMOTENSIVE SMOKERS
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DOI：
10.1016/0026-0495(95)90110-8
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发表时间：
1995-05-01
影响因子：
9.8
通讯作者：
LITHELL, HO
中科院分区：
文献类型：
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作者：
NILSSON, PM;LIND, L;LITHELL, HO
吸烟与血浆脂蛋白模式异常有关。最近，吸烟者中出现了胰岛素抵抗和正常胰岛素作用的报道。在健康调查中招募的总共 191 名高血压和正常血压受试者中，比较了 41 名吸烟者和 150 名非吸烟者的血清脂蛋白脂质、葡萄糖耐量（通过静脉葡萄糖耐量试验（IVGTT）、胰岛素分泌和胰岛素敏感性（正常血糖胰岛素钳夹））。受试者在空腹状态下的早晨和戒烟 10 至 12 小时后进行检查。吸烟者表现出较高水平的胰岛素抵抗。与不吸烟者相比，血红蛋白 Al (HbAI(1c)) 为 4.9% 与 4.7% (P < .05)。 与吸烟者相比，空腹血糖、胰岛素或胰岛素介导的葡萄糖处理方面，许多胰岛素敏感性指标往往显示出胰岛素作用增强。与非吸烟者相比，吸烟者的血清甘油三酯水平预期较高（2.1 vs 1.8 mmol/L，P < .05），并且低密度脂蛋白（LDL）与高密度脂蛋白（HDL）胆固醇的比率增加（4.5 vs 3.9，P < .05）。戒烟阶段没有显示出胰岛素作用受损的迹象，并且 HbA(1c) 升高可能部分是由急性吸烟引起的胰岛素抵抗引起的，因此，对胰岛素敏感性的影响似乎在 10 至 12 小时内是可逆的。
Smoking is associated with an abnormal plasma lipoprotein pattern. Recently, both insulin resistance and normal insulin action have been reported in smokers. In a total of 191 hypertensive and normotensive subjects recruited from a health survey, serum lipoprotein lipids, glucose tolerance (by intravenous glucose tolerance test (IVGTT), insulin secretion, and insulin sensitivity (euglycemic insulin clamp) were compared in the 41 smokers and 150 nonsmokers. Subjects were examined in the morning during a fasting state and after abstinence from smoking for 10 to 12 hours. Smokers showed a higher level of hemoglobin Al, (HbAI(1c)) as compared with nonsmokers, 4.9% versus 4.7% (P < .05). There were no significant differences in fasting glucose, insulin, or insulin-mediated glucose disposal. However, a number of indices of insulin sensitivity tended to show enhanced insulin action among smokers. Only lower glucose and insulin values during the late phase (40 to 90 minutes) of the IVGTT reached statistical significance. Compared with nonsmokers, smokers had an expected higher level of serum triglycerides (2.1 v 1.8 mmol/L, P < .05) and an increased low density lipoprotein (LDL) to high-density lipoprotein (HDL) cholesterol ratio (4.5 v 3.9, P < .05). These differences between smokers and nonsmokers were similar in both hypertensives and normotensives. In conclusion, smokers examined in the abstinence phase showed no signs of impaired insulin action. Lipoprotein abnormalities and elevated HbA(1c) may be caused in part by the insulin resistance induced during acute smoking and therefore may be quantitatively related to the time exposed to smoking. The effect on insulin sensitivity appears to be reversible over 10 to 12 hours. Copyright (C) 1995 by W.B. Saunders Company