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首页> 外文期刊>Diabetes care >Homeostasis model assessment of insulin resistance in relation to the incidence of cardiovascular disease: the san antonio heart study.
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Homeostasis model assessment of insulin resistance in relation to the incidence of cardiovascular disease: the san antonio heart study.

机译：与心血管疾病的发生率相关的胰岛素抵抗的稳态模型评估：圣安东尼奥心脏研究。

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OBJECTIVE-The prospective association between insulin levels and risk of cardiovascular disease (CVD) is controversial. The objective of the present study was to investigate the relationship of the homeostasis model assessment of insulin resistance (HOMA-IR), as well as insulin levels, with risk of nonfatal and fatal CVD over the 8-year follow-up of the San Antonio Heart Study. RESEARCH DESIGN AND METHODS-Between 1984 and 1988, randomly selected Mexican-American and non-Hispanic white residents of San Antonio participated in baseline examinations that included fasting blood samples for glucose, insulin, and lipids, a glucose tolerance test, anthropometric measurements, and a lifestyle questionnaire. Between 1991 and 1996, 2,569 subjects who were free of diabetes at baseline were reexamined using the same protocol. RESULTS-Over the follow-up period, 187 subjects experienced an incident cardiovascular event (heart attack, stroke, heart surgery, angina, or CVD death). Logistic regression analysis indicated that risk of a CVD event increased across quintiles of HOMA-IR after adjustment for age, sex, and ethnicity (P for trend <0.0001; quintile 5 vs. quintile 1, odds ratio [OR] 2.52, 95% CI 1.46-4.36). Additional adjustment for LDL, triglyceride, HDL, systolic blood pressure, smoking, alcohol consumption, exercise, and waist circumference only modestly reduced the magnitude of these associations (P for trend 0.02; quintile 5 vs. quintile 1, OR 1.94, 95% CI 1.05-3.59). Furthermore, there were no significant interactions between HOMA-IR and ethnicity, sex, hypertension, dyslipidemia, glucose tolerance (impaired glucose tolerance versus normal glucose tolerance), or obesity. The magnitude and direction of the relationship between insulin concentration and incident CVD were similar. CONCLUSIONS-We found a significant association between HOMA-IR and risk of CVD after adjustment for multiple covariates. The topic remains controversial, however, and additional studies are required, particularly among women and minority populations.
机译：目的-胰岛素水平与心血管疾病（CVD）风险之间的前瞻性关联存在争议。本研究的目的是研究在圣安东尼奥市的8年随访中，胰岛素抵抗（HOMA-IR）稳态模型评估以及胰岛素水平与非致命性和致命性CVD风险的关系。心脏研究。研究设计与方法-在1984年至1988年之间，从圣安东尼奥市随机抽取的墨西哥裔美国人和非西班牙裔白人居民参加了基线检查，包括空腹血糖，胰岛素和脂质的血液样本，葡萄糖耐量测试，人体测量和生活方式问卷。在1991年至1996年之间，使用相同的方案对2569名基线时没有糖尿病的受试者进行了重新检查。结果-在随访期间，有187名受试者发生了心血管事件（心脏病发作，中风，心脏手术，心绞痛或CVD死亡）。 Logistic回归分析表明，在调整了年龄，性别和种族之后，HOMA-IR的五分位数患CVD事件的风险增加（趋势<0.0001的P;五分位数与五分位数1的比较，优势比[OR] 2.52，95％CI 1.46-4.36）。对LDL，甘油三酸酯，HDL，收缩压，吸烟，饮酒，运动和腰围的其他调整仅适度降低了这些相关性的幅度（趋势0.02的P;五分位数与五分位数1的比例;或1.94,95％CI 1.05-3.59）。此外，HOMA-IR与种族，性别，高血压，血脂异常，葡萄糖耐量（糖耐量降低对正常葡萄糖耐量）或肥胖之间无显着相互作用。胰岛素浓度与入射CVD之间关系的大小和方向相似。结论-我们在调整多个协变量后发现HOMA-IR与CVD风险之间存在显着关联。但是，该主题仍存在争议，还需要进行额外的研究，尤其是在妇女和少数民族人群中。

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