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【medical-news】肥胖个体发生心血管疾病及2型糖尿
Effect of Differences in Insulin Sensitivity
Tracey McLaughlin, MD; Fahim Abbasi, MD; Cindy Lamendola, RN; Gerald Reaven, MD
Arch Intern Med. 2007;167:642-648.
Background The possibility that substantial heterogeneity in metabolic abnormalities exists in moderately obese individuals has not been emphasized in studies of the effect of obesity on morbidity and mortality. We tested the hypothesis that risk factors for type 2 diabetes mellitus and cardiovascular disease vary dramatically in moderately obese individuals as a function of differences in a specific measure of insulin sensitivity.
Methods Participants included 211 apparently healthy, obese (body mass index [calculated as weight in kilograms divided by height in meters squared], 30.0-34.9) volunteers for weight loss studies. Main outcome measures included insulin-mediated glucose uptake as quantified by the insulin suppression test and metabolic variables known to increase the risk for type 2 diabetes and cardiovascular disease.
Results Insulin sensitivity varied 6-fold. When compared with the most insulin-sensitive third, the most insulin-resistant third of the population had significantly higher (P<.001) systolic and diastolic blood pressure (139 ± 20 vs 123 ± 18 mm Hg, and 83 ± 3 vs 75 ± 10 mm Hg, respectively), higher fasting and 2-hour oral glucose load concentrations (103 ± 11 vs 95 ± 11 mg/dL [5.7 ± 0.6 vs 5.3 ± 0.6 mmol/L], and 139 ± 30 vs 104 ± 19 mg/dL [7.7 ± 1.7 vs 5.8 ± 1.1 mmol/L], respectively), higher plasma triglyceride concentrations (198 ± 105 vs 114 ± 51 mg/dL [2.2 ± 1.2 vs 1.3 ± 0.6 mmol/L]), lower plasma high-density lipoprotein cholesterol concentrations (41 ± 9 vs 50 ± 13 mg/dL [1.1 ± 0.2 vs 1.3 ± 0.3 mmol/L]), and more prevalent impaired glucose tolerance (47% vs 2%).
Conclusions The magnitude of risk factors for type 2 diabetes and cardiovascular disease varies markedly in moderately obese individuals as a function of differences in degree of insulin sensitivity. Because not all moderately obese individuals are at similar risk for developing type 2 diabetes and cardiovascular disease, intensive therapeutic interventions should be addressed to the insulin-resistant subset of this population. 本人认领此文. 如在48小时内未能提交译文, 其他战友可自由认领. TITLE:Heterogeneity in the Prevalence of Risk Factors for Cardiovascular Disease and Type 2 Diabetes Mellitus in Obese Individuals
Effect of Differences in Insulin Sensitivity
题：肥胖个体中心血管疾病和2型糖尿病流行的危险因素的差异
胰岛素敏感性差别的作用
Tracey McLaughlin, MD; Fahim Abbasi, MD; Cindy Lamendola, RN; Gerald Reaven, MD
Arch Intern Med. 2007;167:642-648.
Background The possibility that substantial heterogeneity in metabolic abnormalities exists in moderately obese individuals has not been emphasized in studies of the effect of obesity on morbidity and mortality. We tested the hypothesis that risk factors for type 2 diabetes mellitus and cardiovascular disease vary dramatically in moderately obese individuals as a function of differences in a specific measure of insulin sensitivity.
背景 人们在研究肥胖对发病率和死亡率的影响时，还没有重视中度肥胖个体中的代谢异常存在实质性差异的可能性。我们验证了作为胰岛素敏感性尺度差异功能的2型糖尿病和心血管疾病的危险因素在中度肥胖个体中变化极大。
Methods Participants included 211 apparently healthy, obese (body mass index [calculated as weight in kilograms divided by height in meters squared], 30.0-34.9) volunteers for weight loss studies. Main outcome measures included insulin-mediated glucose uptake as quantified by the insulin suppression test and metabolic variables known to increase the risk for type 2 diabetes and cardiovascular disease.
方法 参与减肥研究的为211名明显健康的肥胖（体重指数[以公斤为单位的体重除以以米为单位的升高]在30.0-34.9）志愿者。主要的结果指标为胰岛素抑制试验量化的胰岛素介导的糖摄入量和已知的能提高2型糖尿病和心血管疾病风险的代谢变量。
Results Insulin sensitivity varied 6-fold. When compared with the most insulin-sensitive third, the most insulin-resistant third of the population had significantly higher (P<.001) systolic and diastolic blood pressure (139 ± 20 vs 123 ± 18 mm Hg, and 83 ± 3 vs 75 ± 10 mm Hg, respectively), higher fasting and 2-hour oral glucose load concentrations (103 ± 11 vs 95 ± 11 mg/dL [5.7 ± 0.6 vs 5.3 ± 0.6 mmol/L], and 139 ± 30 vs 104 ± 19 mg/dL [7.7 ± 1.7 vs 5.8 ± 1.1 mmol/L], respectively), higher plasma triglyceride concentrations (198 ± 105 vs 114 ± 51 mg/dL [2.2 ± 1.2 vs 1.3 ± 0.6 mmol/L]), lower plasma high-density lipoprotein cholesterol concentrations (41 ± 9 vs 50 ± 13 mg/dL [1.1 ± 0.2 vs 1.3 ± 0.3 mmol/L]), and more prevalent impaired glucose tolerance (47% vs 2%).
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作者:admin@医学,生命科学 2010-11-19 17:11
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