高胰岛素血症与脉搏波传导速度的相关性分析

目的 探讨高胰岛素血症(HIns)与动脉硬化的相关性.方法 研究对象为北京某单位年度体检人群,除确诊糖尿病者外所有受检者均行口服葡萄糖耐量试验(OGTT),测定空腹和糖负荷后2h血糖、胰岛素水平以评价糖代谢状态,并评估其他心血管危险因素;应用日本COLIN公司VP-2000全自动动脉硬化检测仪检测踝臂脉搏波传导速度(baPWV),分析HIns与baPWV的相关性.结果 参检人群共1046例,不同糖代谢水平(正常糖耐量、糖调节受损和糖尿病)人群中HIns组的baPWV均高于正常胰岛素(NIns)组[正常糖耐量,(1381.2±280.8)cm/s比(1280.3±218.7)cm/s;糖调节受损,(1557.5±319.3)cm/s比(1474.7±305.1)cm/s;糖尿病,(1764.3±476.6)cm/s比(1664.2±374.6)cm/s],且在正常糖耐量人群中两组差异有统计学意义(P＜0.01).HIns人群合并心血管危险因素的比例显著高于NIns人群(P＜0.01).单因素回归分析显示,血清胰岛素水平与baPWV间存在直线回归关系;多因素回归分析显示,在调整性别、年龄、肥胖、高血压、高TG血症和高血糖后,HIns仍是动脉硬化的独立危险因素,其OR(95%CI)为1.91(1.169～3.105),P＜0.01.结论 HIns人群的脉搏波传导速度增加,血清胰岛素水平与baPWV密切相关,HIns是动脉硬化的独立危险因素.

Abstract：

Objective To study the correlation between hyperinsulinemia (HIns) and arteriosclerosis in one community in Beijing. Methods Subjects who received arteriosclerosis screening in physical examination annually were studied. All subjects were received 75g oral glucose tolerance test (OGTT) to evaluate glucose metabolic level, and brachial-ankle pulse wave velocity (baPWV) examination to evaluate arteriosclerosis. The correlation between hyperinsulinemia and pulse wave velocity was analyzed. Results Among all the 1046 subjects under investigation, baPWV of subjects with HIns was higher than subjects with normoinsulinemia (NIns) in different glucose metabolism status [normal glucose tolerance, ( 1381.2 ±280. 8) cm/s vs ( 1280. 3 ±218. 7) cm/s; imparied glucose regulation, ( 1557. 5 ±319.3) cm/s vs (1474.7 ±305. 1) cm/s; diabetes, (1764.3 ±476.6) cm/s vs (1664.2 ±374.6)cm/s], especially in subjects with normal glucose tolerance ( P ＜ 0.01 ). The prevalence of cardiovascular risk factors in subjects with HIns was much higher than subjects with NIns ( P ＜ 0.01 ). Multiple logistic regression analysis showed that hyperinsulinemia was the risk factor of arteriosclerosis, and the OR (95%CI) of subjects with HIns was 1.91 (1. 169-3. 105, P ＜0.01 ) as compared to the subjects with NIns. Conclusion The subjects with HIns suffered from much more metabolic risk factors than NIns.Hyperinsulinemia that closely correlated with baPWV was a risk factor of arteriosclerosis.

The correlation between hyperinsulinemia and pulse wave velocity

Objective To study the correlation between hyperinsulinemia (HIns) and arteriosclerosis in one community in Beijing. Methods Subjects who received arteriosclerosis screening in physical examination annually were studied. All subjects were received 75g oral glucose tolerance test (OGTT) to evaluate glucose metabolic level, and brachial-ankle pulse wave velocity (baPWV) examination to evaluate arteriosclerosis. The correlation between hyperinsulinemia and pulse wave velocity was analyzed. Results Among all the 1046 subjects under investigation, baPWV of subjects with HIns was higher than subjects with normoinsulinemia (NIns) in different glucose metabolism status [normal glucose tolerance, ( 1381.2 ±280. 8) cm/s vs ( 1280. 3 ±218. 7) cm/s; imparied glucose regulation, ( 1557. 5 ±319.3) cm/s vs (1474.7 ±305. 1) cm/s; diabetes, (1764.3 ±476.6) cm/s vs (1664.2 ±374.6)cm/s], especially in subjects with normal glucose tolerance ( P ＜ 0.01 ). The prevalence of cardiovascular risk factors in subjects with HIns was much higher than subjects with NIns ( P ＜ 0.01 ). Multiple logistic regression analysis showed that hyperinsulinemia was the risk factor of arteriosclerosis, and the OR (95%CI) of subjects with HIns was 1.91 (1. 169-3. 105, P ＜0.01 ) as compared to the subjects with NIns. Conclusion The subjects with HIns suffered from much more metabolic risk factors than NIns.Hyperinsulinemia that closely correlated with baPWV was a risk factor of arteriosclerosis.