上海地区40岁以上自然人群中胰岛素抵抗现部及特征分析

目的评价胰岛素抵抗指数(稳态模式评估法HOMA-IR)的可靠性，并应用HOMA-IR估测自然人群中胰岛素抵抗伴发情况。方法联合应用高胰岛素-正葡萄糖钳夹及3-

Study of insulin resistance among Chinese population over 40 in Shanghai area

Objective To evaluate the reliability of homeostasis model assessment (HOMA) for estimating in sulin sensitivity, as well as to investigate the insulin resistance of base-line survey people by HOMA-IR. Methods The hyperinsulinemic-euglycemic clamp combined with 3-3H glucose infusion were performed in 29 Chinese individuals to determine the glucose disposal rate and assess the sensitivity, specificity and accuracy of HOMA-IR (HOMA-insulin resistance index). The current status of insulin sensitivity in Shanghai Huayang community survey( n = 1873)was esti mated by HOMA-IR. Results 1. In comparison with the glucose disposal rate by glucose clamp, the sensitivity、speci ficity、accuracy of HOMA-IR was 86.4% 、71.4% and 82.8%, respectively. 2. In diabetes、impaired glucose tolerance and/or impaired fasting glucose、hypertriglyceridemia and/or low high-density-lipoprotein cholesterol(H-TG/L-HDL)and hypertensives, about 62.5%、41.7%、30.8% and 32.0% suffered from insulin resistance respectively. 3. With the rise of BMI or metabolic disorders, the frequency of insulin insensitivity was also increased (P for trend, P ＜ 0.001 ). 4. Results of logistic regression analysis revealed that insulin resistance had a major effect on hyperglycemia, and that on H-TG/L-HDL being the next. Conclusion HOMA-IR in the estimation of insulin resistance has a higher accuracy, while insulin resistance is common among the adults, especially in those with metabolic disorders. (Shanghai Med J, 2001,24:199-202)