Moderate alcohol consumption, estrogen replacement therapy, and physical activity are associated with increased insulin sensitivity - Is abdominal adiposity the mediator?

被引:65
作者
Greenfield, JR
Samaras, K
Jenkins, AB
Kelly, PJ
Spector, TD
Campbell, LV
机构
[1] St Vincents Hosp, Dept Endocrinol, Sydney, NSW 2010, Australia
[2] Univ Wollongong, Dept Biomed Sci, Wollongong, NSW 2500, Australia
[3] Sequenom Inc, San Diego, CA USA
[4] St Thomas Hosp, Twin Res & Genet Epidemiol Unit, London, England
[5] St Vincents Hosp, Ctr Diabet, Sydney, NSW 2010, Australia
关键词
D O I
10.2337/diacare.26.10.2734
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
OBJECTIVE- To investigate 1) associations between environmental factors (alcohol consumption, hormone replacement therapy [HRT], and physical activity) and insulin resistance and secretion, independent of genetic influences; 2) the contribution of abdominal adiposity to these relationships, and 3) whether gene-environment interactions mediate these associations. RESEARCH DESIGN AND METHODS- Reported effects of lifestyle factors on insulin resistance and secretion are inconsistent, possibly due to difficulty in dissecting environmental from genetic influences and to confounding by adiposity. We examined these relationships in 798 nondiabetic female twins. Insulin resistance and secretion were estimated by modified homeostasis model assessment (HOMA-R' and HOMA-beta', respectively). Percent total body fat and percent central abdominal fat (CAF) were measured by dual-energy X-ray absorptiometry. RESULTS- All categories of alcohol consumption were associated with lower insulin levels and HOMA-beta' than abstinence. Only moderate alcohol consumers (11-20 units/week) had than abstainers (-0.16 +/- 0.09 vs. 0.14 +/- 0.13 SD, P = 0.048). This difference lower HOMA-R derate was attenuated after controlling for percent CAF (P = 0.57), which was lower in moderate drinkers. Controlling for genetic and smoking effects in cotwin case-control analysis, monozy. gotic pairs discordant for alcohol consumption had greater within-pair differences in HOMA-R' than concordant pairs (P = 0.02). Postmenopausal women using estrogen-only HRT had lower HOMA-R' than non-HRT users (-0.33 +/- 0.16 vs. 0.17 +/- 0.08 SD, P = 0.003), even after, controlling for percent CAF. Lower fasting glucose levels and insulin resistance and secretion indexes in physically active subjects were partly explained by lower abdominal adiposity. CONCLUSIONS- Moderate alcohol consumption, estrogen replacement, and physical activity are associated with increased insulin sensitivity in female twins. The favorable effects of moderate alcohol consumption and physical activity on insulin sensitivity are partly mediated by lower abdominal adiposity.
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页码:2734 / 2740
页数:7
相关论文
共 50 条
[21]   Lack of heritability of circulating leptin concentration in humans after adjustment for body size and adiposity using a physiological approach [J].
Jenkins, AB ;
Samaras, K ;
Gordon, MA ;
Snieder, H ;
Spector, T ;
Campbell, L .
INTERNATIONAL JOURNAL OF OBESITY, 2001, 25 (11) :1625-1632
[22]  
Kahn R, 1998, DIABETES CARE, V21, P310
[23]   Glycemic effects of postmenopausal hormone therapy: The heart and estrogen/progestin replacement study - A randomized, double-blind, placebo-controlled trial [J].
Kanaya, AM ;
Herrington, D ;
Vittinghoff, E ;
Lin, F ;
Grady, D ;
Bittner, V ;
Cauley, JA ;
Barrett-Connor, E .
ANNALS OF INTERNAL MEDICINE, 2003, 138 (01) :1-9
[24]  
Kiechl S, 1996, BRIT MED J, V313, P1040
[25]  
KRAEGEN EW, 1999, DIABET ANN, V12, P141
[26]   Central fat predicts deterioration of insulin secretion index and fasting glycaemia: 6-year follow-up of subjects at varying risk of Type 2 diabetes mellitus [J].
Kriketos, AD ;
Carey, DG ;
Jenkins, AB ;
Chisholm, DJ ;
Furler, SM ;
Campbell, LV .
DIABETIC MEDICINE, 2003, 20 (04) :294-300
[27]  
Lazarus R, 1997, AM J EPIDEMIOL, V145, P909, DOI 10.1093/oxfordjournals.aje.a009050
[28]  
LINDHEIM SR, 1993, FERTIL STERIL, V60, P664
[29]  
LINDHEIM SR, 1994, FERTIL STERIL, V62, P1176
[30]   ASSOCIATION OF FASTING INSULIN WITH BLOOD-PRESSURE AND LIPIDS IN YOUNG-ADULTS - THE CARDIA STUDY [J].
MANOLIO, TA ;
SAVAGE, PJ ;
BURKE, GL ;
LIU, K ;
WAGENKNECHT, LE ;
SIDNEY, S ;
JACOBS, DR ;
ROSEMAN, JM ;
DONAHUE, RP ;
OBERMAN, A .
ARTERIOSCLEROSIS, 1990, 10 (03) :430-436