目的探讨中心性肥胖人群颈动脉内膜中层厚度与胰岛素抵抗的相关关系。方法采用REACTION研究中在大连地区参加调查的10207人,选取其中5029例非糖尿病的中心性肥胖人群作为本研究的研究对象。所有受试者均测量身高、体重、腰围、臀围、收缩压、舒张压,同时测定空腹血糖(FPG)、75 g OGTT 2h血糖(2h PG)、空腹胰岛素(FINS)、糖化血红蛋白(Hb A1c)、血尿酸(UA)、甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白(LDL-C)及高密度脂蛋白(HDL-C)、颈动脉内膜中层厚度(CIMT),计算腰臀比、BMI及稳态模型胰岛素抵抗评估指数(HOMA-IR)。根据HOMA-IR值将研究人群分为胰岛素抵抗组(HOMA-IR≥1.73)3247例和非胰岛素抵抗组(HOMA-IR<1.73)1782例。比较上述各指标在两组间的差异,研究HOMA-IR与颈动脉内膜中层厚度的相关关系。结果 (1)胰岛素抵抗和非胰岛素抵抗两组间年龄、CIMT、收缩压、FPG、2h PG、Hb A1c、UA、LDL-C、HDL-C、BMI等指标差异存在显著性意义(P<0.05);(2)偏相关分析显示,在控制年龄、HDL-C、LDL-C、TC、TG、UA及血压等因素的影响后,HOMA-IR仍与CIMT呈正相关(r=0.033,P=0.007);Logistic回归分析显示,年龄、HOMA-IR、腰围、LDL-C是CIMT的独立危险因素(P<0.05)。HDL-C是CIMT的保护因素(P<0.05)。结论胰岛素抵抗是非糖尿病的中心性肥胖人群颈动脉内膜增厚的独立危险因素。 Objective To investigate the relationship between carotid artery intima-media thickness and insulin resistance in central obesity population. Methods A total of 10,207 people who participated in the REACTION study in Dalian area were selected and 5029 non-diabetic central obesity population were selected as the research object. All subjects measured height, weight, waist circumference, hip circumference, systolic blood pressure and diastolic blood pressure. Fasting plasma glucose (FPG), 75 g OGTT 2h blood glucose (2h PG), fasting insulin (FINS), HbA1c UA, TG, TC, LDL-C and HDL-C, carotid artery intima-media thickness (CIMT) , Waist-to-hip ratio, BMI and homeostasis model insulin resistance index (HOMA-IR) were calculated. According to the HOMA-IR value, the study population was divided into 3 groups: 3247 patients with insulin resistance (HOMA-IR≥1.73) and 1782 patients with non-insulin resistance (HOMA-IR <1.73). The differences of these indexes between the two groups were compared to study the correlation between HOMA-IR and carotid artery intima-media thickness. Results There was significant difference in the indexes of age, CIMT, systolic blood pressure, FPG, 2h PG, Hb A1c, UA, LDL-C, HDL-C and BMI between insulin resistance and non-insulin resistance (2) Partial correlation analysis showed that there was a positive correlation between HOMA-IR and CIMT after controlling for age, HDL-C, TC, TG, UA and blood pressure (r = 0.033, P = 0.007). Logistic regression analysis showed that age, HOMA-IR, waist circumference and LDL-C were independent risk factors for CIMT (P <0.05). HDL-C is a protective factor for CIMT (P <0.05). Conclusion Insulin resistance is an independent risk factor for carotid intima-media thickness in non-diabetic central obese people.