Associations of insulin levels with left ventricular structure and function in American Indians - The Strong Heart Study
Associations of insulin levels with left ventricular structure and function in American Indians - The Strong Heart Study
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DOI：
10.2337/diabetes.51.5.1543
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发表时间：
2002-05-01
期刊：
影响因子：
7.7
通讯作者：
Howard, BV
中科院分区：
文献类型：
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作者：
Ilercil, A;Devereux, RB;Howard, BV
我们在强心研究 (SHS) 中评估了 1,388 名非糖尿病美洲印第安人参与者（45% 为男性）胰岛素与超声心动图左心室 (LV) 测量值之间的关联。在男性和女性中，log(10) 空腹胰岛素与左心室质量（r = 0.24 和 0.26）、左心房直径（r = 0.25 和 0.28）、后壁厚度（r = 0.20 和 0.26）、间隔厚度（r = 0.19 和 0.24）、左心室直径（r = 0.17 和 0.16）、心输出量（r = 0.20 和 0.24）以及女性的相对壁厚（r = 0.11）和外周阻力（r = -0.17）。在回归分析中，调整BMI、年龄、身高和收缩压后，空腹胰岛素与男性的心输出量以及女性的相对壁厚度和间隔厚度独立相关（所有P < 0.05）。 163 名明显正常（BMI < 26；血压 < 140/90；且无糖尿病、瓣膜病、左心室壁运动异常或抗高血压治疗）的 163 名 SHS 参与者的空腹胰岛素第 97 个百分位（男性 25 muU/ml，女性 23 muU/ml）被用来区分正常和升高的空腹胰岛素水平。调整年龄、BMI和身高后，胰岛素水平升高的男性左心室直径较大（5.41 vs. 5.16 cm；P = 0.05），心输出量较高（5.5 vs. 4.9 l/min；P < 0.001），外周阻力较低（1,487 vs. 1,666；P = 0.01），与回归分析结果一致。非糖尿病成年人的胰岛素和心脏大小之间的正相关关系很大程度上是由于与身体大小的相关性。调整协变量后，空腹胰岛素水平与男性更大的左室尺寸和心输出量以及女性更同心的左室几何形状相关。
We evaluated the association of insulin and echocardiographic left ventricular (LV) measurements in 1,388 (45% men) nondiabetic American Indian participants in the Strong Heart Study (SHS). Significant (all P < 0.05) relations were found in men and women between log(10) fasting insulin and LV mass (r = 0.24 and 0.26), left atrial diameter (r = 0.25 and 0.28), posterior wall thickness (r = 0.20 and 0.26), septal thickness (r = 0.19 and 0.24), LV diameter (r = 0.17 and 0.16), and cardiac output (r = 0.20 and 0.24) and in women relative wall thickness (r = 0.11) and peripheral resistance (r = -0.17). In regression analyses, adjusting for BMI, age, height, and systolic pressure, fasting insulin was independently correlated with cardiac output in men and relative wall thickness and septal thickness in women (all P < 0.05). The 97th percentiles of fasting insulin (25 muU/ml for men, and 23 muU/ml for women) in 163 apparently normal (BMI < 26; blood pressure < 140/90; and absence of diabetes, valvular disease, LV wall motion abnormality, or antihypertensive treatment) SHS participants were used to separate normal from elevated fasting insulin levels. Adjusting for age, BMI, and height, men with elevated insulin levels had larger LV diameters (5.41 vs. 5.16 cm; P = 0.05), higher cardiac output (5.5 vs. 4.9 l/min; P < 0.001), and lower peripheral resistance (1,487 vs. 1,666; P = 0.01), paralleling results of regression analyses. Positive relations between insulin and heart size in nondiabetic adults are largely due to associations with body size; after adjustments for covariates, fasting insulin levels are related to greater LV size and cardiac output in men and more concentric LV geometry in women.