2型糖尿病颈动脉粥样硬化与血脂及胰岛素抵抗的关系

目的 探讨2型糖尿病(T2DM)患者颈动脉粥样硬化(AS)与血脂及胰岛素抵抗的关系,为有效预防和控制AS的发生发展提供科学依据.方法 选择沈阳医学院沈洲医院93例T2DM患者作为研究对象,测量患者颈动脉内中膜厚度(IMT)、斑块情况.根据IMT值将T2DM患者分为3组:单纯糖尿病(DM)组32例,中膜增厚组31例,斑块组30例.选取健康对照组30例.测定血脂、血糖、胰岛素抵抗指数(HOMA-IR).结果 IMT与空腹血糖(FPG)、空腹胰岛素(FINS)、HOMA-IR、甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、脂蛋白a(Lp-a)呈正相关,与高密度脂蛋白胆固醇( HDL-C)、载脂蛋白A1(ApoA1)呈负相关,均有统计学意义(P＜0.01).logistic回归分析结果显示,TC是T2DM颈AS的危险因素(OR=23.649,95％ CI:2.410～232.104),HDL-C(OR=0.008,95％ CI:0.000～0.279)、载脂蛋白B(OR=0.000,95％CI:0.000～0.101)是保护因素.结论 T2DM颈AS与血脂及胰岛素抵抗密切相关.

Association of Carotid Atherosclerosis with Serum Lipid and Insulin Resistance in Type 2 Diabetes Mellitus

Objective To investigate the relationship of carotid atherosclerosis（AS） with insulin resistance and serum lipid in type 2 diabetes mellitus（T2DM）.Methods A total of 93 patients with T2DM were recruited and further divided into 3 groups according to carotid intima-media thickness（IMT）,32 cases in DM group,31 cases in IMT incrassation group and 30 cases in AS plaque group.At the same time,30 healthy controls were selected.Carotid IMT and plaque were detected.Serum levels of glycemia and serum lipid were determined.Results The IMT was positively correlated with FPG,FINS,HOMA-IR,TG,TC,LDL-C and Lp-a,and negatively with HDL-C and ApoA1（P0.01）.TC was an independently risk factor for carotid atherosclerosis of T2DM（OR=23.649,95% CI：2.410~232.104）,while HDL-C（OR=0.008,95% CI：0.000~0.279） and ApoB（OR=0.000,95% CI：0.000~0.101） were protective factors.Conclusion The severity of carotid atherosclerosis in T2DM is closely associated with serum lipid and Insulin resistance.