新发2型糖尿病患者睡眠时间与胰岛素抵抗的相关性

目的：探讨新发2型糖尿病患者睡眠时间与胰岛素抵抗的相关性。方法选取2014-2015年在我院内分泌代谢科住院的新发2型糖尿病患者72例，根据睡眠时间长短分为睡眠时间<6h/晚、6~8h/晚、>8h/晚三个组。记录并比较三组患者的一般情况、体质量指数(BMI)、糖化血红蛋白(HbA1c)、总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白(LDL)、高密度脂蛋白(HDL)、空腹血糖(FPG)、空腹胰岛素(FINS)，以胰岛素抵抗指数(HOMA-IR)来评价胰岛素抵抗。结果在新发2型糖尿病中，与睡眠时间6~8 h/晚组相比，睡眠时间<6 h/晚组患者的BMI、腰围、收缩压(SBP)、舒张压(DBP)、TG、LDL、FPG、FINS、HOMA-IR、HbA1c等明显增高，HDL明显降低，差异均有统计学意义(P<0.05)；与睡眠时间6~8 h/晚组相比，睡眠时间>8 h/晚组患者的BMI、腰围、TG、LDL、FPG、FINS、HOMA-IR、HbA1c明显增高，差异均有统计学意义(P<0.05)；与睡眠时间<6 h/晚组相比，睡眠时间>8 h/晚组患者的SBP、DBP、LDL、FPG、FINS、HOMA-IR、HbA1c明显降低，差异有统计学意义(P<0.05)。结论睡眠时间不足或过长都有可能出现血脂、血糖、血压等的升高，导致代谢紊乱，加重胰岛素抵抗，尤其是睡眠时间不足影响更明显，可能是新发2型糖尿病的危险因素。

Relationship between sleep duration and insulin resistance in patients with newly diagnosed type 2 diabetes mellitus

Objective To study the relationship between sleep duration and insulin resistance in patients with newly diagnosed type 2 diabetes mellitus. Methods A total of 72 patients with newly diagnosed type 2 diabetes melli-tus in Department of Endocrine and Metabolic Diseases in our hospital from 2014 to 2015 were selected. According to the length of sleep duration, all patients were divided into 3 groups by the sleep time:<6 h/night (group A), 6~8 h/night (group B) and>8 h/night (group C). The general situations, body mass index (BMI), hemoglobin A1c level (HbA1c), to-tal cholesterol (TC), triglyceride (TG), low density lipoprotein (LDL), high density lipoprotein (HDL), fasting plasma glucose (FPG), fasting insulin concentration (FINS) were recorded and compared, and the insulin resistance was as-sessed by homeostasis model assessment of insulin resistance (HOMA-IR). Results Compared with the group B, the BMI, waist circumferences, systolic blood pressur (SBP), diastolic blood pressure (DBP), TG, LDL, FPG, FINS, HOMA-IR, HbA1c of group A were significantly increased, and the HDL was significantly reduced in patients with newly diagnosed type 2 diabetes, with statistically significant differences (P<0.05). Compared with the group B, the BMI, waist circumferences, TG, LDL, FPG, FINS, HOMA-IR, HbA1c in group C were significantly increased, and the differences were statistically significant (P<0.05). Compared with the group A, the SBP, DBP, LDL, FPG, FINS, HOMA-IR, HbA1c in group C were significantly reduced, and the differences were statistically significant (P<0.05). Conclusion Both the short sleep duration and the long sleep duration could result in the rise of blood lipids, blood pressure and blood glucose, then cause metabolic disturbance and aggravate insulin resistance. In particular, the former's effect is more obvious, which may be a risk factor for newly diagnosed type 2 diabetes mellitus.