2型糖尿病胰岛素抵抗与糖尿病性心功能不全的观察

目的 探讨2型糖尿病(T2DM)胰岛素抵抗导致糖尿病性心功能不全的临床表现特点及相关激素的改变.方法 2008年1-4月对T2DM患者35例(胰岛素抵抗指数HOMA-IR<2.69者19例为A1组,HOMA-IR≥2.69者16例为A2组)及健康体检者20人B组测体重指数(BMI)、空腹血糖(FPG)、胰岛素、心钠素(...

Clinical Observation of Insulin Resistance and Diabetic Cardiac Insufficiency in Type 2 Diabetes Mellitus

Objective To investigate the clinical features and related hormone changes of diabetic cardiac insufficiency leaded by insulin resistance in type 2 diabetes mellitus（T2DM）.Methods From January to April 2008,35 patients with T2DM（group A1： HOMA-IR〈2.69,n=19;group A2： HOMA-IR≥ 2.69,n=16） and 20 subjects without T2DM（group B） were enrolled.The body mass index（BMI）,fasting plasma glucose（FPG）,insulin（FINS）,atrial natriuretic peptide（ANP）,brain natriuretic peptide（BNP）,and E/A,e/a,S/D,LVEF and DT stage of all subjects were detected.Results The BMI in group A2 was higher than those in group A1 and group B（P〈0.05）,while the difference between the later two groups was not statistically significant（P〉0.05）.The ANP,BNP and DT stage were all higher than those in group B（P〈0.05）,the BNP was higher in group A2 than in group A1（P〈0.05）,while the difference of neither ANP nor DT stage between the later two groups was statistically significant（P〉0.05）.The values of E/A,e/a and S/D in group A1 and A2 were all lower than those in group B（P〈0.05）,while there were no statistically significant diferences between group A1 and A2（P〉0.05）.The values of LVEF of group A1 and A2 were both significantly reduced than that in group B（P〈0.05）,and the values in group A2 were the lowest（P〈0.05）.Conclusions With the aggravating of insulin resistance,myocardial contractility and diastolic function will decline,meanwhile the ANP and BNP secretion will increase,and then the clinical and echocardiographic manifestation will appear