2型糖尿病胰岛素抵抗与心血管疾病部分危险因素的相关分析

目的　了解胰岛素抵抗性与部分心血管危险因素间的关系。方法　选取初诊 2型糖尿病 (T2DM)患者 4 8例和正常对照 11例 ,通过改良的高胰岛素正血糖钳夹方法测定胰岛素敏感性 (ISI) ,与体重指数 (BMI)、腰 /臀比例、血压、TG、TCH、LDL CH、HDL CH和空腹血浆胰岛素 (FINS )做相关分析。结果　T2DM患者ISI和HDL CH低于正常人(均P <0 0 5 ) ,TG、TCH、LDL CH、空腹血浆葡萄糖 (FPG)和FINS水平高于正常人 (均P <0 0 5 )。肥胖T2DM患者ISI低于非肥胖T2DM患者 ,而TG和FINS水平高于非肥胖T2DM患者 (均P <0 0 5 )。双变量相关分析显示 ,T2DM患者ISI与腰 /臀比例、收缩压、舒张压、LDL CH和HDL CH相关 (均P <0 0 1) ,与TG、TCH无相关性 ;偏相关分析ISI仅与腰 /臀比例、舒张压和HDL CH相关 (均P <0 0 5 )。结论　T2DM患者胰岛素抵抗性增加 ,具有更高的心血管疾病风险 ,尤其是腹型肥胖者

Correlation analysis of insulin resistance and known cardiovascular risk factors in type 2 diabetes mellitus

Objective To explore relation of insulin sens itivity(ISI) to known cardiovascular risk factors in type 2 diabetes mellitus (T2DM). M ethods 59 cases were enrolled in the study including 48 T2DM and 11 controls. ISI was measured by modulated euglycemia hyperinsulinemia clamp method. Correlation betw een ISI and known cardiovascular risk factors were analyzed. Results The values of ISI and HDL-CH were lower, and the values of TG, TCH, LDL-CH , FPG and FINS were higher in T2DM than in controls (all P<0 05). The value of ISI was lower, however, TG and LDL-CH were higher in T2DM with obesity than normal (all P<0 05). The correlations of ISI to W/H ratio, blood pressure, LDL-CH and HDL-CH were found by Pearson correlation analysis(all P<0 01 ). But only the correlations of ISI to W/H ratio, HDL-CH and diastolic pressure were found by Partial correlation analysis(all P<0 05). Conclusio n The risk of cardiovascular diseases is increased when insulin resistanc e is exaggerated in T2DM, especially with abdominal obesity.