Risk variable clustering in the insulin resistance syndrome - The Framingham Offspring Study
Risk variable clustering in the insulin resistance syndrome - The Framingham Offspring Study
复制标题
DOI：
10.2337/diabetes.46.10.1594
复制
发表时间：
1997-10-01
期刊：
影响因子：
7.7
通讯作者：
Singer, DE
中科院分区：
文献类型：
--
作者：
Meigs, JB;DAgostino, RB;Singer, DE
胰岛素抵抗被认为是高血压、糖耐量减低、高胰岛素血症、甘油三酯水平升高和高密度脂蛋白水平降低以及中心性和全身性肥胖的统一聚集。我们用因子分析检验了这一假设，因子分析是一种统计技术，如果这些危险变量的聚集是单一过程的话，它应该识别一个因素。从2,458名弗雷明翰后代研究的非糖尿病受试者中，我们收集了临床数据、空腹和挑战后2小时血糖和胰岛素水平以及空腹血脂水平，我们分别对整个人群中的男性和女性以及具有胰岛素抵抗综合征特征的亚组进行了因子分析，受试者年龄从26岁到82岁(平均年龄54岁)；53%是女性，13.4%有糖耐量受损，27.6%有高血压，40%肥胖，11.6%只是高胰岛素血症，定义为空腹胰岛素水平升高。这些风险变量聚集的基础是三个因素，空腹和挑战后2小时胰岛素水平，空腹甘油三酯和高密度脂蛋白水平，BMI和腰臀比与一个因素相关，空腹和2小时血糖和胰岛素水平与第二个因素相关，收缩压、舒张压和BMI与第三个因素相关，结果在男性和女性以及所有亚组中相似，这些结果与潜在风险变量聚集的不止一个独立的生理过程一致：中枢代谢综合征(以高胰岛素血症、血脂异常和肥胖为特征)、糖耐量异常和高血压。葡萄糖耐量异常和高血压通过与胰岛素水平的共同相关性与中枢综合征联系在一起，肥胖、胰岛素抵抗(反映为高胰岛素血症)本身似乎并不是胰岛素抵抗综合征的所有特征。
Insulin resistance has been hypothesized to unify the clustering of hypertension, glucose intolerance, hyperinsulinemia, increased levels of triglyceride and decreased HDL cholesterol, and central and overall obesity We tested this hypothesis with factor analysis, a statistical technique that should identify one factor if a single process underlies the clustering of these risk variables, From 2,458 nondiabetic subjects of the Framingham Offspring Study, we collected clinical data, fasting and 2-h postchallenge glucose and insulin levels, and fasting lipid levels, We performed factor analyses separately for men and women in the entire population and among subgroups with features of the insulin resistance syndrome, Subjects ranged in age from 26 to 82 years (mean age 54); 53% were women, 13.4% had impaired glucose tolerance, 27.6% had hypertension, 40% were obese, and 11.6% mere hyperinsulinemic, defined by elevated fasting insulin levels. Underlying the clustering of these risk variables were three factors, Fasting and 2-h postchallenge insulin levels, fasting triglyceride and HDL cholesterol levels, BMI, and waist-to-hip ratio were associated with one factor, Fasting and 2-h levels of glucose and insulin were associated with a second factor, Systolic blood pressure, diastolic blood pressure, and BMI were associated with a third factor, Results were similar for men and women and for all subgroups, These results were consistent with more than one independent physiological process underlying risk variable clustering: a central metabolic syndrome (characterized by hyperinsulinemia, dyslipidemia, and obesity), glucose intolerance, and hypertension. Glucose intolerance and hypertension were linked to the central syndrome through shared correlations with insulin levels and obesity insulin resistance (reflected by hyperinsulinemia) alone did not appear to underlie all features of the insulin resistance syndrome.