2型糖尿病患者血分析指标的变化及临床意义

 目的探讨胰岛素抵抗与血分析指标(包括红细胞计数,血红蛋白,红细胞压积等)的相关性.方法研究421例病程不大于1 a,空腹血糖不大于7.8 mmol/L,无其他系统疾病,未服用口服降糖药物的2型糖尿病患者,根据稳态模型评估(HOMA)评价胰岛素抵抗程度.结果红细胞计数与HOMA成正相关,同时也与其他胰岛素抵抗指标相关.胰岛素抵抗程度重的患者(高4分位)红细胞计数、甘油三酯、总胆固醇、体重指数(BMI)、腰臀比(WHR)比胰岛素抵抗轻(低4分位)患者高.结论胰岛素抵抗与红细胞生成相关,可能是胰岛素抵抗综合症的新表现,可能使糖尿病血管并发症危险性增加.

Changes and clinical significance of blood analytical indices in patients with type 2 diabetes

Objectives To explore the relationship between insulin resistance and blood analytical indices,including red cell count,plasma hemoglobin, hematocrit, etc. Methods We studied 421 diabetic patients without adninistration of antidiabetic drug, whose fasting blood glucose was less than 7.8 mmol/L,duration of diabetes les than 1 year, without any other systemic disease.The degree of insulin resistance was calculated according to the homeostasis model assessment(HOMA).Results The red cell count positively correlated with HOMA and the other biological markers of insulin resistance syndrome. Subjects with higher insulin resistance (higher quartile) had high blood cell count, fasting serum insulin, serum triglyceride, serum cholesterol, body mass index, and waist to hip ratio( WHR) than the subjects at low quartiles of insulin resistance. Conclusions Insulin resistance correlates with erythropoiesis. In- creased red blood cell count may be consideredas a new aspect of insulin resistance syndrome, which may contribute to the development of diabetic cardiovascular complication.