维汉两族患者的胰岛素敏感指数与冠状动脉粥样硬化程度的关系

目的：探讨维汉两族患者胰岛素敏感指数（ISI）与冠状动脉粥样硬化程度的关系。方法：选择125例冠心病患者，其中维吾尔族59例，汉族66例；稳定性心绞痛42例、不稳定性心绞痛52例、陈旧性心肌梗死31例、2型糖尿病患者53例、高血压病患者35例，收集患者的相关病史（年龄、人体质量指数），进行实验室检查（血脂，空腹血糖、空腹胰岛素等），及冠状动脉造影评价冠脉病变程度。计算ISI，并分析其与冠状动脉粥样硬化病变程度的关系。结果：ISI在两族人群中均与冠状动脉粥样硬化程度呈负相关（汉族：r=-0．71，P=0．03，维族：r=-0．52，P=0．04），在汉族患者中与人体质量指数呈负相关，与糖化血红蛋白（（HbAlc））及低密度脂蛋白-胆固醇（LDL-c）呈负相关（r=-0．45、-0．68、-0．55，P均〈0．05）；在维吾尔族患者中与高密度脂蛋白-胆固醇（HDL—C）正相关（r=0．67，P〈0．01），与（HbAlc）、LDL-C、脂蛋白a呈负相关（r=-0．47、-0．35、-0．42，P〈0．05）。结论：胰岛素抵抗参与并促进冠状动脉粥样硬化斑块的形成及发展，控制维汉两族冠心病患者体重，降低血糖，LDL-C等水平均可减少胰岛素抵抗，预防冠心病的发生、发展。

Relationship between insulin sensitivity index and extent of coronary atherosclerosis in Uygur and Han nationality patients

Objective: To explore the relationship between insulin sensitivity index(ISI)and extent of coronary atherosclerosis in Uygur and Han nationality patients.Methods: A total of 125 patients with coronary heart disease were enrolled,including 59 Uygur nationality patients and 66 Han nationality patients.There were 42 cases with stable angina pectoris,52 cases with unstable angina pectoris,31 cases with old myocardial infarction,53 cases with type 2 diabetes and 35 cases with hypertension.Relevant medical history of patients age,body mass index(BMI)etc.] was collected and laboratory examination(blood lipid,fasting blood glucose,fasting insulin etc.)were performed,and extent of coronary atherosclerosis was evaluated by coronary angiography in all patients.ISI was calculated and its relationship with extent of coronary atherosclerosis was analyzed.Results: In both nationality patients,ISI was negatively correlated with extent of coronary atherosclerosis(Han nationality: r=-0.71,P=0.03,Uygur nationality: r=-0.52,P=0.04).ISI was negatively correlated with BMI,glycosylated hemoglobin(HbA1c) and low density lipoprotein cholesterol(LDL-C)(r=-0.45,-0.68,-0.55,P<0.05 all) in Han nationality patients;ISI was positively correlated with high density lipoprotein cholesterol(HDL-C,r=0.67,P<0.01),and negatively correlated with HbA1c,LDL and lipoprotein a(r=-0.47,-0.35,-0.42,P<0.05) in Uygur nationality patients.Conclusion: Insulin resistance participates and promotes formation and development of coronary atherosclerotic plaques.Controlling weight,blood glucose and LDL-C levels etc.can decrease insulin resistance and prevent occurrence and development of coronary heart disease.