IGT患者糖负荷后血脂变化及其与胰岛素抵抗的关系

目的了解IGT患者口服葡萄糖耐量试验后的血脂变化情况,探讨糖负荷后血脂及其与胰岛素抵抗的关系.方法选自我院IGT患者100例.测定空腹血浆葡萄糖、HbAlc、空腹胰岛素、总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)后,给与75 g葡萄糖行口服葡萄糖耐量试验(OGTT),测定糖负荷后60分、120分和180分的血浆葡萄糖、胰岛素、TC、TG、LDL-C、HDL-C.并计算胰岛素抵抗指数(Homa-IR)及负荷后血脂曲线下面积(Y-AUC).结果糖负荷后60 min、120 min、180 min的TG、HDL-C、LDL-C和TC浓度明显低于空腹各血脂浓度.Homa-IR与TG(三个时段)呈正相关,Homa-IR与HDL-C(三个时段)呈负相关,此外,Homa-IR与其它血脂成分比较无统计学意义.结论 IGT患者糖负荷血脂浓度较空腹时低,但Homa-IR与TG(三个时段)关系密切.提示合理应用调脂药物,改善胰岛素抵抗不但有利于血糖控制,也有利于血脂代谢的改善,从而延缓心血管疾病合并症的发生.

Relationships Between changes of blood lipid after sugar load and insulin resistance in patients with impaired glucose tolerance(IGT)

Objective To study changes of blood lipid after patients with impaired glucose tolerance(IGT) had an oral glucose tolerance test(OGTT).And research Relationships Between changes of blood lipid after sugar load and insulin resistance.Methods 100 patients with IGT were selected in our hospital.The plasma glucose,their plasma insulin fasting insulin,HbAlc,blood lipidserum triglycerides(TG),total cholesterol(TC),lower density lipoprotein cholesterol(LDL-C),high density lipoprotein cholesterol(HDL-C)were measured.After Proceeding oral glucose tolerance test(OGTT),we measured the plasma glucose,plasma insulin,HbAlc,blood lipid(TG,TC,LDL-C,HDL-C)at an hour,two hours and three hours after sugar load,then we calculated homeostasis model assessment of insulin resistance(HOMA-IR),area under curve of blood lipid after sugar load(Y-AUC).Results TG, TC,LDL-C,HDL-C at an hour,two hours and three hours after sugar load were significant decreased than their fasting concentration.HOMA-IR was positively correlated to TG,negatively correlated to HDL-C,while no significant difference was found with other blood lipid.Conclusion The concentration of blood lipid after sugar load were significant decreased than their fasting concentration in patients with IGT.Homa-IR was closely connected TG.It is shown that use adjusting blood lipid drugs reasonably may decreased insulin resistance and improve the lever of glucose and lipid metabolism,and may defer large blood vessel complication.