Hyperinsulinemia predicts coronary heart disease risk in healthy middle-aged men -: The 22-year follow-up results of the Helsinki Policemen Study
Hyperinsulinemia predicts coronary heart disease risk in healthy middle-aged men -: The 22-year follow-up results of the Helsinki Policemen Study
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DOI：
10.1161/01.cir.98.5.398
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发表时间：
1998-08-04
期刊：
影响因子：
37.8
通讯作者：
Pyörälä, K
中科院分区：
文献类型：
--
作者：
Pyörälä, M;Miettinen, H;Pyörälä, K
背景--赫尔辛基警察研究是最早的前瞻性流行病学研究之一，证实了高胰岛素血症与冠心病（CHD）风险的相关性。本研究的目的是调查高胰岛素血症的预测价值与冠心病的风险，在22年的随访期间的赫尔辛基警察研究population.Methods和Results-The研究是基于一个队列的970名男性谁是34至64岁，无冠心病，其他心血管疾病和糖尿病。基线检查时的风险因素测量包括口服葡萄糖耐量试验（OGTT），在0、1和2小时测量血糖和血浆胰岛素。OGTT期间血浆胰岛素反应曲线下面积（AUC胰岛素）用作反映血浆胰岛素水平的复合变量。在22年的随访中，164名男性发生了重大CHD事件（CHD死亡或非致命性心肌梗死）。在5年、10年、15年和22年随访期间，将AUC胰岛素五分位数最高的男性与AUC胰岛素五分位数较低的四分位数合并的男性进行比较，主要CHD事件的风险比为3.29（95% CI，1.56至6.91）、2.72（95% CI，1.67至4.42）、2.14（95% CI，1.43至3.21）和1.61（95% CI，1.14至2.27）。进一步调整其他风险因素，将这些风险比降至2.36（95% CI，1.00 - 5.57），2.29（95% CI，1.31 - 4.02），1.76（95% CI，1.09 - 2.82）和1.32（95%CI，0.84 - 1.97），分别。结论-高胰岛素血症预测冠心病的风险，在赫尔辛基警察超过22年的后续行动，并且在很大程度上独立于其他CHD危险因素，但其预测价值随着随访时间的延长而降低。
Background-The Helsinki Policemen Study is one of the first prospective epidemiological studies demonstrating an association of hyperinsulinemia to the risk of coronary heart disease (CHD). The aim of the present study was to investigate the predictive value of hyperinsulinemia with regard to CHD risk during a 22-year follow-up of the Helsinki Policemen Study population.Methods and Results-The study was based on a cohort of 970 men who were 34 to 64 years of age and free of CHD, other cardiovascular disease, and diabetes. Risk factor measurements at baseline examination included an oral glucose tolerance test (OGTT) with blood glucose and plasma insulin measurements at 0, 1, and 2 hours. Area under the plasma insulin response curve (AUC insulin) during OGTT was used as a composite variable reflecting plasma insulin levels. During the 22-year follow-up, 164 men had a major CHD event (CHD death or nonfatal myocardial infarction). Age-adjusted hazard ratios for a major CHD event comparing men in the highest AUC insulin quintile with those in the combined 4 lower quintiles during 5-, 10-, 15-, and 22-year follow-up periods were 3.29 (95% CI, 1.56 to 6.91), 2.72 (95% CI, 1.67 to 4.42), 2.14 (95% CI, 1.43 to 3.21), and 1.61 (95% CI, 1.14 to 2.27), respectively. Further adjustment for other risk factors attenuated these hazard ratios to 2.36 (95% CI, 1.00 to 5.57), 2.29 (95% CI, 1.31 to 4.02), 1.76 (95% CI, 1.09 to 2.82), and 1.32 (95% CI, 0.84 to 1.97), respectively.Conclusions-Hyperinsulinemia predicted CHD risk in Helsinki policemen over the 22-year follow-up, and to a large extent independently of other CHD risk factors, but its predictive value diminished with lengthening follow-up time.