老年糖尿病并发脑梗死与胰岛素抵抗的关系

目的　探讨老年 2型糖尿病合并脑梗死与胰岛素抵抗的关系。方法　检测 35例老年 2型糖尿病无脑梗死患者 ,2 5例 2型糖尿病合并脑梗死患者及 2 2例非糖尿病脑梗死患者的糖化血红蛋白 (HbA1c)、血浆葡萄糖 (PG)、胰岛素 (INS)、C肽 (CP)水平 ,并计算出胰岛素敏感指数 (ISI)、胰岛素曲线下面积 (AUCins)、C肽曲线下面积 (AUCcp)。结果　糖尿病合并脑梗死患者行口服葡萄糖耐量试验 (OGTT)后 1、2、3hINS显著高于糖尿病无脑梗死患者 分别为(5 4 .77± 17.4 7)mU L (6 4 .86± 19.78)mU L、(74 .89± 2 1.94 )mU L (87.4 1± 2 3.15 )mU L、(44 .2 4± 13.94 )mU L (5 3.84± 19.5 7)mU L ,P <0 .0 5 ];而ISI则显著低于糖尿病无脑梗死患者 (0 .72± 0 .36 0 .93± 0 .4 7,P <0 .0 5 )。非糖尿病脑梗死患者 1、2、3hINS均显著低于糖尿病脑梗死患者 分别为 (41.2 6± 17.6 7)mU L (6 4 .86± 19.78)mU L、(47.0 1± 18.73)mU L (87.4 1± 2 3.15 )mU L、(35 .4 6± 12 .5 3)mU L (5 3.84± 19.5 7)mU L ,P <0 .0 1];而ISI则显著高于糖尿病脑梗死患者 (1.11± 0 .36 0 .72± 0 .36 ,P <0 .0 5 )。结论　老年 2型糖尿病患者不管是否合并脑梗死 ,均存在胰岛素抵抗 ,合并脑梗死者胰岛素抵抗更为明显

Relationship between cerebral infarction and insulin resistance in elderly diabetic patients

Objective To study the relationship between cerebral infarction and insulin resistance in elderly diabetic patients.Methods 35 diabetic patients without cerebral infarction and 25 diabetic patients with cerebral infarction were studied.22 cerebral infarction patients without diabetes mellitus served as control.Plasma glucose,glucosylated hemoglobin(HbA1c),insulin(INS) and C peptide(CP) were measured. Insulin sensibility index(ISI),area under curve of insulin(AUCins)? area under curve of C peptide(AUCcp) were calculated.Results 1 h INS,2 h INS,3 h INS were higher in diabetic patients with cerebral infarction than in those without cerebral infarction(54.77±17.47) mU/L vs (64.86±19.78) mU/L,(74.89±21.94) mU/L vs (87.41±23.15) mU/L,(44.24±13.94) mU/L vs (53.84±19.57) mU/L,WTBX]P<0.05].ISI was lower in .ISI was lower in diabetic patients with cerebral infarction than in those without cerebral infarction ( 0.93±0.47 vs 0.72±0.36 ;P<0.05).1 h INS,2 h INS?3 h INS were lower in cerebral infarction patients without diabetes than in those with diabetes (41.26±17.67) mU/L vs (64.86±19.78) mU/L,(47.01±18.73) mU/L vs (87.41±CM)] 23.15) mU/L,(35.46±12.53) mU/L vs (53.84±19.57) mU/L,P<0.01].ISI was higher in cerebral infarction patients without diabetes than in those with diabetes (1.11±0.36 vs 0.72±0.36,.ISI was higher in cerebral infarction patients without diabetes than in those with diabetes (1.11±0.36 vs 0.72±0.36,P<0.05).Conclusion There is insulin resistance (IR) in all elderly diabetic patients with or without cerebral infarction,but IR is higher in those with cerebral infarction.