Relationship between plasma insulin and left ventricular mass in normotensive participants of the Gubbio Study.
Relationship between plasma insulin and left ventricular mass in normotensive participants of the Gubbio Study.
复制标题
古比奥研究血压正常的参与者血浆胰岛素与左心室质量之间的关系。
DOI：
10.1046/j.1365-2265.2003.01715.x
复制
发表时间：
2003
影响因子：
3.2
通讯作者：
GubbioStudyResearchGroup
中科院分区：
文献类型：
--
作者：
Vaccaro,Olga;Cardoni,Ondina;Cuomo,Vincenzo;Panarelli,Walter;Laurenzi,Martino;Mancini,Mario;Riccardi,Gabriele;Zanchetti,Alberto;GubbioStudyResearchGroup
背景有大量但非决定性的证据表明胰岛素抵抗与高血压患者的左心室质量（LVM）有关。这种关联在多大程度上是由血浆胰岛素与体型和体型之间的关系介导的仍然存在争议，并且在非高血压人群中的研究很少。目的为了在古比奥研究的非高血压参与者的人群样本中探讨胰岛素或胰岛素抵抗与 LVM 之间的关系。方法在参与基于人群的筛查的 91 名 45-54 岁非糖尿病、非高血压个体中测定了超声心动图 LVM。分析中使用身高 2·7 归一化的 LVM；左心室肥厚的定义为男性值≥ 50 g/m2·7，女性值≥ 47 g/m2·7。测定空腹血浆胰岛素和血糖，并采用稳态模型评估（HOMA）指数作为胰岛素抵抗的衡量标准。结果LVM与体重指数（BMI）（P<0·01）、腰围（P<0·01）和HOMA指数（P<0·05）呈显着正相关，而与血糖和甘油三酯的相关性未达到统计学意义（均P=0·07）；调整 BMI 后，所有相关性都被抵消。空腹血浆胰岛素和 HOMA 指数在有或没有左心室肥厚的受试者中没有显着差异（分别为 70·8 ± 27·8 与 77·7 ± 29·6 pmol/l 和 2·2 ± 1·0 与 2·6 ± 1·4）。双变量分析对 BMI（男性和女性分别为 29·1 和 29·4 kg/m2）和血浆胰岛素（男性和女性分别为 84 pmol/l）性别分布第 75 个百分位数以上或以下的参与者进行了分层，并没有因胰岛素水平而导致 LVM 出现明显差异。在分析中替代胰岛素的 HOMA 指数得到了类似的结果。结论在非高血压个体中，左心室质量与血浆胰岛素无关，独立于体重指数。
backgroundThere is substantial but not conclusive evidence that insulin resistance is related to left ventricular mass (LVM) in hypertensive individuals. To what extent this association is mediated by the relationship between plasma insulin and body size and build is still debated, and is poorly explored in nonhypertensive people.objectiveTo explore the relationship between insulin or insulin resistance and LVM in a population‐based sample of nonhypertensive participants of the Gubbio Study.methodEchocardiographic LVM was determined in 91 nondiabetic, nonhypertensive individuals aged 45–54 years, participating in a population‐based screening. LVM normalized for height2·7was used in the analyses; LV hypertrophy was defined as a value of ≥ 50 g/m2·7in men or ≥ 47 g/m2·7in women. Fasting plasma insulin and glucose were measured and the Homeostasis Model Assessment (HOMA) index was used as a measure of insulin resistance.resultsLVM was positively and significantly correlated with body mass index (BMI) (P< 0·01), waist circumference (P< 0·01) and HOMA index (P< 0·05), whereas correlations with plasma glucose and triglycerides did not reach statistical significance (P= 0·07 for both); all correlations were offset after adjusting for BMI. Fasting plasma insulin and HOMA index were not significantly different in subjects with or without LV hypertrophy (70·8 ± 27·8vs.77·7 ± 29·6 pmol/l and 2·2 ± 1·0vs.2·6 ± 1·4, respectively). Bivariate analysis performed stratifying participants above or below the 75th percentile of the sex‐specific distribution for BMI (29·1 and 29·4 kg/m2for males and females, respectively) and plasma insulin (84 pmol/l for either gender), did not result in appreciable differences in LVM due to insulin levels. Similar results were obtained replacing the HOMA index for insulin in the analysis.conclusionIn nonhypertensive individuals left ventricular mass is not associated with plasma insulin independently of body mass index.