Proinsulin and insulin concentrations in relation to carotid wall thickness -: Insulin Resistance Atherosclerosis Study
Proinsulin and insulin concentrations in relation to carotid wall thickness -: Insulin Resistance Atherosclerosis Study
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DOI：
10.1161/01.str.29.8.1498
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发表时间：
1998-08-01
期刊：
影响因子：
8.3
通讯作者：
Saad, MF
中科院分区：
文献类型：
--
作者：
Haffner, SM;D'Agostino, R;Saad, MF
背景和目的——胰岛素抵抗和高胰岛素血症与动脉粥样硬化有关。最近的注意力集中在胰岛素原的可能作用上，因为大多数胰岛素放射免疫测定会与胰岛素原发生交叉反应。因此，尚不清楚胰岛素本身或胰岛素原两者中哪一个与动脉粥样硬化关系更密切。 方法 - 我们通过胰岛素抵抗研究了 985 名非糖尿病受试者的空腹胰岛素原、空腹胰岛素原、空腹和 2 小时胰岛素（口服葡萄糖负荷后）以及颈总动脉 (CCA) 和颈内动脉 (ICA) 内膜中层壁厚度 (IMT) 之间的关系动脉粥样硬化研究，一项关于胰岛素抵抗和动脉粥样硬化的多种族研究。结果-在总体人群中，观察到胰岛素原与 CCA IMT 之间存在微弱但显着的关系（r=0.07，P=0.029），然而，胰岛素原与 IMT 之间的关系在西班牙裔和非西班牙裔白人中比非裔美国人更强。在非西班牙裔白人和西班牙裔中，观察到 CCA 与胰岛素原 (r=0.087) 之间以及 ICA 与胰岛素原 (r=0.101)、裂解胰岛素原 (r=0.092) 和空腹胰岛素 (r=0.087) 之间存在显着相关性。在调整心血管危险因素，特别是纤溶酶原激活剂抑制剂-1 (PAI-1) 后，显着相关性变得更加减弱（并且不显着）。结论 - 胰岛素原和 IMT 之间的关联虽然较弱，但似乎比胰岛素和 IMT 之间的关联更强。对 PAI-1 的调整显着减弱了胰岛素原和 IMT 之间的关联，表明 PAI-1 在这种关联中可能具有中介作用。胰岛素原可能代表动脉粥样硬化的标志物，而不是动脉粥样硬化的致病因素。使用胰岛素作为胰岛素抵抗替代物的胰岛素抵抗综合征和动脉粥样硬化研究应考虑使用特定的胰岛素测定以及胰岛素原浓度的测定。
Background and Purpose-insulin resistance and hyperinsulinemia have been associated with atherosclerosis. Recent attention has focused on the possible role of proinsulin because most radioimmunoassays for insulin cross-react with proinsulin. Therefore, it is not known which of the two, insulin per se or proinsulin, is more strongly related to atherosclerosis.Methods-We examined the relation between fasting proinsulin, fasting split proinsulin, fasting and 2-hour insulin (after oral glucose load), and intima-media wall thickness (IMT) in the common carotid artery (CCA) and internal carotid artery (ICA) in 985 nondiabetic subjects from the Insulin Resistance Atherosclerosis Study, a multiethnic study of insulin resistance and atherosclerosis.Results-In the overall population, a weak but significant relation between proinsulin and CCA IMT was observed (r=0.07, P=0.029), However, the relation between proinsulin and IMT was stronger in Hispanics and non-Hispanic whites than in African Americans. In non-Hispanic whites and Hispanics, significant correlations between CCA and proinsulin (r=0.087) and between ICA and proinsulin (r=0.101), split proinsulin (r=0.092), and fasting insulin (r=0.087) were observed. The significant correlations became more attenuated (and nonsignificant) after adjustment for cardiovascular risk factors, especially plasminogen activator inhibitor-1 (PAI-1),Conclusions-The association between proinsulin and IMT, while weak, appears to be stronger than the association between insulin and IMT. Adjustment for PAI-1 markedly attenuated the association between proinsulin and IMT, suggesting a possible mediating role for PAI-1 in this association, It is possible that proinsulin may represent a marker of atherosclerosis rather than a causal factor for atherosclerosis, Studies of the insulin resistance syndrome and atherosclerosis that use insulin as a surrogate for insulin resistance should consider the use of specific insulin assays as well as determination of proinsulin concentrations.