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Titolo:
Insulin sensitivity in subjects with type 2 diabetes - Relationship to cardiovascular risk factors: the Insulin Resistance Atherosclerosis Study
Autore:
Haffner, SM; DAgostino, R; Mykkanen, L; Tracy, R; Howard, B; Rewers, M; Selby, J; Savage, PJ; Saad, MF;
Indirizzi:
Univ Texas, Hlth Sci Ctr, Dept Med, San Antonio, TX 78284 USA Univ Texas San Antonio TX USA 78284 , Dept Med, San Antonio, TX 78284 USA WakeCForest Univ, Bowman Gray Sch Med, Dept Publ Hlth Sci, Winston Salem, N Wake Forest Univ Winston Salem NC USA 27103 bl Hlth Sci, Winston Salem, N Univ Vermont, Sch Med, Dept Pathol, Burlington, VT 05405 USA Univ VermontBurlington VT USA 05405 ept Pathol, Burlington, VT 05405 USA Medlant Res Inst, Penn Med Lab, Washington, DC USA Medlant Res Inst Washington DC USA nst, Penn Med Lab, Washington, DC USA UnivSAolorado, Hlth Sci Ctr, Dept Prevent Med & Biometr, Denver, CO 80262 U Univ Colorado Denver CO USA 80262 event Med & Biometr, Denver, CO 80262 U Kaiser Permanente, Div Res, Oakland, CA USA Kaiser Permanente Oakland CA USA er Permanente, Div Res, Oakland, CA USA Univ So Calif, Med Ctr, Div Diabet Hypertens & Nutr, Los Angeles, CA USA Univ So Calif Los Angeles CA USA t Hypertens & Nutr, Los Angeles, CA USA NHLBI, Div Epidemiol & Clin Applicat, Rockville, MD USA NHLBI Rockville MD USA Div Epidemiol & Clin Applicat, Rockville, MD USA
Titolo Testata:
DIABETES CARE
fascicolo: 4, volume: 22, anno: 1999,
pagine: 562 - 568
SICI:
0149-5992(199904)22:4<562:ISISWT>2.0.ZU;2-N
Fonte:
ISI
Lingua:
ENG
Soggetto:
PLASMINOGEN-ACTIVATOR INHIBITOR-1; CORONARY-ARTERY DISEASE; GLUCOSE-TOLERANCE; ADIPOSE-TISSUE; CAROTID ATHEROSCLEROSIS; ESSENTIAL-HYPERTENSION; PLASMA-INSULIN; VISCERAL FAT; WOMEN; NIDDM;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
48
Recensione:
Indirizzi per estratti:
Indirizzo: Haffner, SM Univ84exas, Hlth Sci Ctr, Dept Med, 7703 Floyd Curl Dr, San Antonio, TX 782 Univ Texas 7703 Floyd Curl Dr San Antonio TX USA 78284 TX 782
Citazione:
S.M. Haffner et al., "Insulin sensitivity in subjects with type 2 diabetes - Relationship to cardiovascular risk factors: the Insulin Resistance Atherosclerosis Study", DIABET CARE, 22(4), 1999, pp. 562-568

Abstract

OBJECTIVE - Among nondiabetic subjects, insulin resistance has been associated with increased cardiovascular risk factors, including dyslipidemia, hypertension, impaired fibrinolysis, and coagulation. Less is known about therelationship between insulin resistance and cardiovascular risk factors insubjects with type 2 diabetes. RESEARCH DESIGN AND METHODS - to examine this issue, we determined insulinsensitivity (S-1) in 479 type 2 diabetic subjects by minimal model analyses of frequently sampled intravenous glucose tolerance tests in the Insulin Resistance Atherosclerosis Study (IRAS), a large multicenter study of insulin sensitivity and cardiovascular disease in African-Americans, Hispanics, and non-Hispanic whites. We defined insulin-sensitive subjects as having S-1 greater than or equal to 1.61 X 10(-4) min(-1) . mu U-1 . ml(-1) (above median in nondiabetic subjects of all ethnic groups in the IRAS). Using thisdefinition, only 37 type 2 diabetic subjects were insulin sensitive, and the remaining 442 were insulin resistant. RESULTS - After adjustment for age, sex, ethnicity and clinic, insulin resistance was significantly correlated with total triglycerides, VLDL cholesterol, VLDL triglyceride, fibrinogen, PAI-1, and fasting glucose, and was inversely correlated with HDL cholesterol level and LDL size. Carotid intimal-medial thickness was greater in insulin-resistant than in insulin-sensitive subjects, but this difference was nor statistically significant. After further adjustment for waist circumference (marker of visceral adiposity), insulin resistant subjects continued to have higher plasminogen activator inhibitor 1 and VLDL triglyceride levels, lower HDL cholesterol levels, and smaller LDL particle size than did insulin-sensitive subjects. After further adjustment for fasting glucose levels, these results were very similar. CONCLUSIONS - We conclude that insulin-resistant type 2 diabetic subjects have more atherogenic cardiovascular risk factor profiles than insulin-sensitive type 2 diabetic subjects and that this is only partially related to increased obesity and an adverse body fat distribution.

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Documento generato il 30/11/20 alle ore 16:12:02