摘要
目的探讨血管内皮功能与胰岛素抵抗(IR)和代谢综合征(MS)发生的联系。方法 2000年筛查出的单纯超重和肥胖者[体质指数(BMI)≥25kg/m^2]583例,测量腰围、血压,测定血脂、血糖,计算BMI、腰臀比、HOMA-IR以及内皮依赖性血管舒张(EDD)功能。7 a后对上述人群进行随访,并复查上述指标。结果 7 a后共发生MS者177人,占随访对象的33.78%。按基线资料分组结果显示,MS的累积发生率在EDD异常组和EDD异常并IR组分别为38.14%和48.11%。明显高于IR组的25.00%(P<0.05和P<0.01)和EDD正常并IR组的13.48%(均P<0.01),IR组高于EDD正常并IR组(P<0.05)。随访前后比较,EDD异常组的EDD较初访时增加(P<0.05),而IR组和EDD异常并IR组较初访时降低(P<0.05)。EDD异常组和EDD异常并IR组HOMA-IR较初访时升高(P<0.01和P<0.05)。Logistic分析显示,基线时EDD异常发生MS的风险是EDD正常者的4.17倍,伴有IR的人群发生MS的风险是不伴IR人群的3.21倍。同时具备EDD异常和IR者发生MS的风险是两者都不具备者的5.64倍。结论内皮功能障碍可能是IR和MS各种心血管危险因素发生和聚集的共同病因。
Objective To investigate the relationship between vascular endothelial function and insulin resistance （IR） and the incidence of metabolic syndrome （MS）. Methods A seven-year follow-up study was conducted in 583 simple obese subjects who were chosen in 2000. Body fat, blood pressure, lipid profile, plasma glucose, insulin resistance index （HOMA-IR） and endotheliumdependent dilatation （EDD） were measured before and after the follow-up. Results A total of 177 new cases with MS were found during this seven years, which was 33.78% of all subjects who were followed up in 2007. Cumulative incidence of MS among seven-year was 38.14% in the impaired EDD group and 48.11% in the impaired EDD with IR group, beth rates were higher than that of the IR group （25.00%） （P〈0.05 and P〈0.01） and the normal EDD with non-IR group （13.48%） （all P〈0.01）. The cumulative incidence of MS in the IR group was higher than that of the normal EDD with non-IR group （P〈0.05）. At the end of the seventh year, the rate of EDD was significantly increased in impaired EDD group and decreased in IR group and in the impaired EDD with IR group compared （P〈0.05）, and HOMA-IR was increased in impaired EDD group and in the impaired EDD with IR group compared with that in original survey （P〈 0.01 and P〈0.05）. Logistic analysis showed that the risk of MS was increased 4.17 folds （P〈0.01） in subjects with impaired EDD and 3.21 folds （P〈0.05） in subjects with IR, and 5.64 folds in both impaired EDD and IR （P〈0.01）. Conclusion Endothelial dysfunction may be a common pathogen of IR and MS for cardiovascular diseases.
出处
《中国慢性病预防与控制》
CAS
2008年第6期561-563,共3页
Chinese Journal of Prevention and Control of Chronic Diseases
关键词
代谢综合征
内皮功能
胰岛素抵抗
随访
Metabolic syndrome
Endothelial function
Insulin resistnee
Follow-up study
