2型糖尿病患者糖负荷后血脂紊乱与颈动脉内中膜厚度关系

目的了解2型糖尿病糖负荷后血脂紊乱的变化及其与颈动脉内中膜厚度关系.方法选自2型糖尿病患者65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、120和180 min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).应用彩色多普勒超声诊断仪,取左右两侧颈动脉测量的6次检测值的平均值即为颈动脉IMT(CAIMT).结果糖负荷后60、120、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.CAIMT(mm)与Homa-IR呈正相关.结论 2型糖尿病患者糖负荷血脂浓度较空腹时低,CAIMT(mm)与Homa-IR的关系密切,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.

Relationship between blood fat disturbance and carotid internal media thickness (CAIMT) after sugar test (OGTT) in 2 type DM patients

Objective To study the relationship between blood fat disturbance and carotid intemal media thickness(CAMT) after sugar test in 2 type DM.Methods 65 cases of patients with 2 type DM were contained.Blood glucose,HB Alc?Insulin?Totle cholesterol(TC)?Triglyceride(TG)?LDL-C and HDL-C were determinated before OGTT and 60min?120 min and 180 min after OGTT.Calculated the insulin resistamce index(Homa-IR) and Y-AUC.And measured the CAIMT of two side for and 180 in fter OGTT.Calculated the Insulin resistance index(Homa-IR) and Y-AUC.And measured the CAIMT of two side for six times.Results The concentrations of TG?HDL-C?LDL-C and TC at 60min?120min and 180min after OGTT were markedly lower than those before.Homa-IR was positive related to TG(At three times),Homa-IR was negative related to HDL-C(At three times).And CAIMT(mm) was positive related to Homa-IR.Conclusion The concentrations of blood fat after OGTT were markedly lower than those before,CAIMT(mm) was closely related to Homa-IR,these showed that making retional use of blood fat regulator,improving Insulin resistance were not only good to controlling blood glucose,but also good to improving the metabolism of blood fat,and the complications followed cardiovascular disease were delayed.