RESOURCE: Diabetes Care Publish Ahead of Print published online ahead of print April 27, 2007
来源：《糖尿病护理》杂志 ，2007年4月27日印刷前网络刊
DOI: 10.2337/dc07-0358
标识码：10.2337/dc07-0358
TITLE: Insulin Sensitivity and Insulin Secretion Determined by the Homeostasis Model Assessment (HOMA) and Risk of Diabetes Mellitus in a Multi-Ethnic Cohort of Women: The Women's Health Initiative Observational Study
Yiqing Song, MD, ScD, JoAnn E. Manson, MD, DrPH, Lesley Tinker, PhD, RD, Barbara V. Howard, PhD, Lewis H. Kuller, MD, DrPH, Lauren Nathan, MD, Nader Rifai, PhD and Simin Liu, MD, ScD
题目：稳态模型评估法(HOMA)确定的胰岛素敏感性和分泌功能及不同种族妇女队列糖尿病发病风险：妇女健康观察的初步研究
作者：Yiqing Song, MD, ScD, JoAnn E. Manson, MD, DrPH, Lesley Tinker, PhD, RD, Barbara V. Howard, PhD, Lewis H. Kuller, MD, DrPH, Lauren Nathan, MD, Nader Rifai, PhD and Simin Liu, MD, ScD
ABSTRACT
OBJECTIVE: The homeostasis model assessment (HOMA) based on plasma levels of fasting glucose and insulin has been widely validated and applied for quantifying insulin resistance and ß-cell function. However, prospective data regarding its relation to diabetes risk in ethnically diverse populations are limited.
摘要：
目的：稳态模型评估法(HOMA)是以空腹时血浆中血糖和胰岛素的水平为基础，该方法已得到印证并广泛用于评价胰岛素耐受能力和ß细胞功能。然而，通过该模型得到的不同种族糖尿病患病风险的前瞻性资料还非常有限。
RESEARCH DESIGN AND METHODS: Among 82,069 women aged 50 to 79 years free of cardiovascular disease or diabetes participating in the Women's Health Initiative Observational Study (WHI-OS), we conducted a nested case-control study to prospectively examine the relations of HOMA-insulin resistance (HOMA-IR) and ß-cell function (HOMA-% with diabetes risk. During a median follow-up period of 5.9 years, 1,584 diabetes patients were matched with 2,198 controls by age, ethnicity, clinical center, time of blood draw, and follow-up time.
研究设计和方法：我们观察了82,069名50到79岁的妇女，这些妇女根据妇女健康观察的初步研究无心血管疾病或糖尿病，通过巢式病例对照研究我们对HOMA－胰岛素耐受(HOMA-IR)与ß细胞功能(HOMA-%）在糖尿病发表中的关系进行了前瞻性研究。
RESULTS: Baseline levels of fasting glucose, insulin, and HOMA-IR were each significantly higher among cases than controls while HOMA-%B was lower (all P values<0.0001). After adjustment for matching factors and diabetes risk factors, all four markers were significantly associated with diabetes risk; the estimated relative risks (RRs) per standard deviation increment were 3.54 (95% CI, 3.02-4.13) for fasting glucose, 2.25 (1.99-2.54) for fasting insulin, 3.40 (2.95-3.92) for HOMA-IR, and 0.57(0.51-0.63) for HOMA-%B.
结果： 当HOMA-%B较低时，病例组空腹血糖、胰岛素和HOMA-IR的基础水平都明显高于对照组。将匹配因子和糖尿病风险因子调整后，所有4个因素均与糖尿病发病风险明显相关；估计的相对风险值(RRs)/标准差的增加值对于空腹血糖为3.54(95% CI, 3.02-4.13)，空腹胰岛素为2.25(1.99-2.54)，HOMA-IR为3.40(2.95-3.92)，HOMA-%B为0.57(0.51-0.63)。
While no statistically significant multiplicative interactions were observed between these markers and ethnicity, the associations of both HOMA-IR and HOMA-%B with diabetes risk remained significant and robust in each ethnic group including Whites, Blacks, Hispanics, and Asians/Pacific Islanders. When evaluated jointly, the relations of HOMA-IR and HOMA-%B with diabetes risk appeared to be independent and additive. HOMA-IR was more strongly associated with an increased risk than were other markers after we excluded those with a fasting glucose 126 mg/dl at baseline.
尽管这些因素和种族间没有明显的具有统计学意思的交互作用，但在每一组内（包括白种人、黑人、西班牙人和亚洲人/太平洋岛屿居民），HOMA-IR和HOMA-%B与糖尿病患病风险之间的关系还是非常明显的。当综合评价时，HOMA-IR和HOMA-%B与糖尿病患病风险之间的关系似乎是相互独立的，并且具有叠加性。我们将那些空腹血糖基线值为126 mg/dl的病例剔除后发现，HOMA-IR与其它因素相比，与糖尿病患病风险增加有更强的联系。
CONCLUSIONS: High HOMA-IR and low HOMA%B were independently and consistently associated with an increased diabetes risk in a multi-ethnic cohort of US postmenopausal women. These data suggest the values of HOMA indices for diabetes risk in epidemiologic studies.
结论：在不同种族的美国绝经后妇女中，高HOMA-IR和低HOMA%B是增加糖尿病患病风险的独立因素。这些资料说明在流行病学研究中HOMA指标对判断糖尿病风险具有重要价值。
编译后：约600字
Song Y及其同事对稳态模型评估法评估不同种族妇女糖尿病患病风险进行了研究，结果发表在2007.4.27《糖尿病护理》杂志网络版。稳态模型评估法(HOMA)是以空腹时血浆中血糖和胰岛素的水平为基础，该方法已得到印证并广泛用于评价胰岛素耐受能力和ß细胞功能。然而，通过该模型得到的不同种族糖尿病患病风险的前瞻性资料还非常有限。
研究人员观察了82,069名50到79岁的妇女，这些妇女根据妇女健康观察的初步研究无心血管疾病或糖尿病，通过巢式病例对照研究他们对HOMA－胰岛素耐受(HOMA-IR)与ß细胞功能(HOMA-%）在糖尿病发表中的关系进行了前瞻性研究。研究人员发现，当HOMA-%B较低时，病例组空腹血糖、胰岛素和HOMA-IR的基础水平都明显高于对照组。将匹配因子和糖尿病风险因子调整后，所有4个因素均与糖尿病发病风险明显相关；估计的相对风险值(RRs)/标准差的增加值对于空腹血糖为3.54(95% CI, 3.02-4.13)，空腹胰岛素为2.25(1.99-2.54)，HOMA-IR为3.40(2.95-3.92)，HOMA-%B为0.57(0.51-0.63)。尽管这些因素和种族间没有明显的具有统计学意思的交互作用，但在每一组内（包括白种人、黑人、西班牙人和亚洲人/太平洋岛屿居民），HOMA-IR和HOMA-%B与糖尿病患病风险之间的关系还是非常明显的。当综合评价时，HOMA-IR和HOMA-%B与糖尿病患病风险之间的关系似乎是相互独立的，并且具有叠加性。研究人员将那些空腹血糖基线值为126 mg/dl的病例剔除后发现，HOMA-IR与其它因素相比，与糖尿病患病风险增加有更强的联系。
据此，研究人员认为在不同种族的美国绝经后妇女中，高HOMA-IR和低HOMA%B是增加糖尿病患病风险的独立因素。这些资料说明在流行病学研究中HOMA指标对判断糖尿病风险具有重要价值。
感觉翻译地比较吃力，战友们多多赐教！
