AIM: To investigate the association between true insulin and proinsulin and clustering of cardiovascular risk factors.METHODS: Based on the random stratified sampling principles, 1196 Chinese people (533 males and 663...AIM: To investigate the association between true insulin and proinsulin and clustering of cardiovascular risk factors.METHODS: Based on the random stratified sampling principles, 1196 Chinese people (533 males and 663 females,aged 35-59 years with an average age of 46.69 years) were recruited. Biotin-avidin based double monoclonal antibody ELISA method was used to detect the true insulin and proinsulin, and a risk factor score was set to evaluate individuals according to the number of risk factors.RESULTS: The median (quartile range) of true insulin and proinsulin was 4.91 mIu/L (3.01-7.09 mIu/L) and 3.49 pmol/L (2.14-5.68 pmol/L) respectively, and the true insulin level of female subjects was significantly higher than that of male subjects (P = 0.000), but the level of proinsulin displayed no significant difference between males and females (P = 0.566). The results of covariate ANOVA after age and sex were controlled showed that subjects with any of the risk factors had a significantly higher true insulin level (P = 0.002 for hypercholesterolemia, P = 0.021 for high low-density lipoprotein cholesterol, P = 0.003 for low high-density lipoprotein cholesterol, and P = 0.000 for other risk factors) and proinsulin level (P = 0.001 for low high-density lipoprotein cholesterol, and P = 0.000 for other risk factors)than those with no risk factors. Furthermore, subjects with higher risk factor scores had a higher true insulin and proinsulin level than those with lower risk factor scores (P = 0.000). The multiple linear regression models showed that true insulin and proinsulin were significantly related to cardiovascular risk factor scores respectively (P = 0.000).CONCLUSION: True insulin and proinsulin are significantly associated with the clustering of cardiovascular risk factors.展开更多
背景：他汀类药物既可降低致动脉粥样硬化脂蛋白，也可降低心血管病的发病率和死亡率。然而，其最佳降脂方案和目标值仍未确定。目的：比较强化降脂和中度降脂方案对冠状动脉粥样斑块大小及其进展的影响。设计、地点和病例：双盲、随机...背景：他汀类药物既可降低致动脉粥样硬化脂蛋白，也可降低心血管病的发病率和死亡率。然而，其最佳降脂方案和目标值仍未确定。目的：比较强化降脂和中度降脂方案对冠状动脉粥样斑块大小及其进展的影响。设计、地点和病例：双盲、随机和有效对照的多中心试验(积极降脂逆转动脉粥样硬化[Reversal or Atherosclerosis with Aggressive Lipid Lowering，REVERSAL])，试验于美国34个社区和三级保健中心对应用两种不同他汀治疗18个月的患者进行了疗效比较。用血管内超声测量动脉硬化的进展。从1994年7月至2001年9月，654例患者随机接受研究药物；其中502例在基线时和治疗18个月后，具有可用的血管内超声检查资料。干预：患者随机接受中度降脂(40mg普伐他汀)方案或强化降脂(80mg阿托伐他汀)方案。主要观察指标：一级疗效指标是动脉粥样斑块体积百分比变化(随诊与基线之间的差值)。结果：两组平均基线低密度脂蛋白胆固醇(LDL-C)水平是150．2mg／dL(3．8mmol／L)。治疗后，普伐他汀组LDL-C降至110mg／dL(2．85mmol／L)，阿托伐他汀组降至79mg／dL(2．05mmol／L)(P<0．001)。C-反应蛋白普伐他汀组降低5．2％，阿托伐他汀组降低36．4％(P<0．001)。阿托伐他汀组动脉粥样斑块进展速度(一级终点：斑块体积百分比变化，P=0．02)显著降低；两组间二级终点指标差异相似，包括总粥样斑块体积(P：0．02)、斑块体积变化百分比(P<0．001)以及最严重病变处10mien血管段斑块体积变化(P<0．01)。与基线比较，一级终点冠状动脉粥样硬化进展的发生率普伐他汀组为2．7％(95％CI，0．2％～4．7％；P=0．001)。阿托伐他汀组无冠状动脉病变进展发生(-0．4％；95％CI，-2．4％～1．5％；P=0．98)。结论：对于冠心病患者，与普伐他汀比较，阿托伐他汀强化降脂治疗可减慢冠状动脉粥样硬化的进展。与基线比较，阿托伐他汀组动脉粥样斑块负荷无变化，而普伐他汀治疗组则显示冠状动脉粥样硬化进展。这些差异可能与阿托伐他汀在降低致动脉粥样硬化脂蛋白和C-反应蛋白方面的作用有关。展开更多
文摘AIM: To investigate the association between true insulin and proinsulin and clustering of cardiovascular risk factors.METHODS: Based on the random stratified sampling principles, 1196 Chinese people (533 males and 663 females,aged 35-59 years with an average age of 46.69 years) were recruited. Biotin-avidin based double monoclonal antibody ELISA method was used to detect the true insulin and proinsulin, and a risk factor score was set to evaluate individuals according to the number of risk factors.RESULTS: The median (quartile range) of true insulin and proinsulin was 4.91 mIu/L (3.01-7.09 mIu/L) and 3.49 pmol/L (2.14-5.68 pmol/L) respectively, and the true insulin level of female subjects was significantly higher than that of male subjects (P = 0.000), but the level of proinsulin displayed no significant difference between males and females (P = 0.566). The results of covariate ANOVA after age and sex were controlled showed that subjects with any of the risk factors had a significantly higher true insulin level (P = 0.002 for hypercholesterolemia, P = 0.021 for high low-density lipoprotein cholesterol, P = 0.003 for low high-density lipoprotein cholesterol, and P = 0.000 for other risk factors) and proinsulin level (P = 0.001 for low high-density lipoprotein cholesterol, and P = 0.000 for other risk factors)than those with no risk factors. Furthermore, subjects with higher risk factor scores had a higher true insulin and proinsulin level than those with lower risk factor scores (P = 0.000). The multiple linear regression models showed that true insulin and proinsulin were significantly related to cardiovascular risk factor scores respectively (P = 0.000).CONCLUSION: True insulin and proinsulin are significantly associated with the clustering of cardiovascular risk factors.
文摘背景：他汀类药物既可降低致动脉粥样硬化脂蛋白，也可降低心血管病的发病率和死亡率。然而，其最佳降脂方案和目标值仍未确定。目的：比较强化降脂和中度降脂方案对冠状动脉粥样斑块大小及其进展的影响。设计、地点和病例：双盲、随机和有效对照的多中心试验(积极降脂逆转动脉粥样硬化[Reversal or Atherosclerosis with Aggressive Lipid Lowering，REVERSAL])，试验于美国34个社区和三级保健中心对应用两种不同他汀治疗18个月的患者进行了疗效比较。用血管内超声测量动脉硬化的进展。从1994年7月至2001年9月，654例患者随机接受研究药物；其中502例在基线时和治疗18个月后，具有可用的血管内超声检查资料。干预：患者随机接受中度降脂(40mg普伐他汀)方案或强化降脂(80mg阿托伐他汀)方案。主要观察指标：一级疗效指标是动脉粥样斑块体积百分比变化(随诊与基线之间的差值)。结果：两组平均基线低密度脂蛋白胆固醇(LDL-C)水平是150．2mg／dL(3．8mmol／L)。治疗后，普伐他汀组LDL-C降至110mg／dL(2．85mmol／L)，阿托伐他汀组降至79mg／dL(2．05mmol／L)(P<0．001)。C-反应蛋白普伐他汀组降低5．2％，阿托伐他汀组降低36．4％(P<0．001)。阿托伐他汀组动脉粥样斑块进展速度(一级终点：斑块体积百分比变化，P=0．02)显著降低；两组间二级终点指标差异相似，包括总粥样斑块体积(P：0．02)、斑块体积变化百分比(P<0．001)以及最严重病变处10mien血管段斑块体积变化(P<0．01)。与基线比较，一级终点冠状动脉粥样硬化进展的发生率普伐他汀组为2．7％(95％CI，0．2％～4．7％；P=0．001)。阿托伐他汀组无冠状动脉病变进展发生(-0．4％；95％CI，-2．4％～1．5％；P=0．98)。结论：对于冠心病患者，与普伐他汀比较，阿托伐他汀强化降脂治疗可减慢冠状动脉粥样硬化的进展。与基线比较，阿托伐他汀组动脉粥样斑块负荷无变化，而普伐他汀治疗组则显示冠状动脉粥样硬化进展。这些差异可能与阿托伐他汀在降低致动脉粥样硬化脂蛋白和C-反应蛋白方面的作用有关。
