Relationship between obesity, insulin resistance, and coronary heart disease risk
Relationship between obesity, insulin resistance, and coronary heart disease risk
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DOI：
10.1016/s0735-1097(02)02051-x
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发表时间：
2002-09-04
影响因子：
24
通讯作者：
Reaven, GM
中科院分区：
文献类型：
--
作者：
Abbasi, F;Brown, BW;Reaven, GM
目的 研究目标是： 1) 确定 314 名非糖尿病、血压正常的健康志愿者的体重指数 (BMI) 与胰岛素抵抗之间的关系； 2) 确定这两个变量与冠心病 (CHD) 危险因素之间的关系。 背景 肥胖作为 2 型糖尿病和高血压的危险因素的重要性已得到充分认识，但其在非糖尿病、血压正常个体中作为 CHD 危险因素的作用尚不明确。 方法 通过测定 180 分钟的最后 30 分钟内的稳态血浆葡萄糖 (SSPG) 浓度来量化胰岛素抵抗。输注奥曲肽、葡萄糖和胰岛素。此外，还测量了志愿者的九个 CHD 危险因素：年龄、收缩压、舒张压 (DBP)、总胆固醇、甘油三酯 (TG)、高密度脂蛋白 (HDL) 胆固醇和低密度脂蛋白胆固醇浓度，以及对 75 克口服葡萄糖负荷的葡萄糖和胰岛素反应。 结果 BMI 和 SSPG 浓度显着相关（r = 0.465，p < 0.001）。 BMI 和 SSPG 均与九个危险因素独立相关。在多元回归分析中，SSPG 浓度在预测 DBP、HDL 胆固醇和 TG 浓度以及葡萄糖和胰岛素反应方面为 BMI 添加了适度到显着的功效。 结论 肥胖和胰岛素抵抗都是 CHD 风险的有力预测因子，任何特定肥胖程度的胰岛素抵抗都会加剧 CHD 和 2 型糖尿病的风险。
OBJECTIVES The study goals were to: 1) define the relationship between body mass index (BMI) and insulin resistance in 314 nondiabetic, normotensive, healthy volunteers; and 2) determine the relationship between each of these two variables and coronary heart disease (CHD) risk factors.BACKGROUND The importance of obesity as a risk factor for type 2 diabetes and hypertension is well-recognized, but its role as a CHD risk factor in nondiabetic, normotensive individuals is less well established.METHODS Insulin resistance was quantified by determining the steady-state plasma glucose (SSPG) concentration during the last 30 min of a 180-min infusion of octreotide, glucose, and insulin. In addition, nine CHD risk factors: age, systolic blood pressure, diastolic blood pressure (DBP), total cholesterol, triglycerides (TG), high-density lipoprotein (HDL) cholesterol and low-density lipoprotein cholesterol concentrations, and glucose and insulin responses to a 75-g oral glucose load were measured in the volunteers.RESULTS The BMI and the SSPG concentration were significantly related (r = 0.465, p < 0.001). The BMI and SSPG were both independently associated with each of the nine risk factors. In multiple regression analysis, SSPG concentration added modest to substantial power to BMI with regard to the prediction of DBP, HDL cholesterol and TG concentrations, and the glucose and insulin responses.CONCLUSIONS Obesity and insulin resistance are both powerful predictors of CHD risk, and insulin resistance at any given degree of obesity accentuates the risk of CHD and type 2 diabetes.