胰岛素抵抗与糖尿病三级预防关系的探讨

目的：探讨胰岛素抵抗与2型糖尿病（T2DM）三级预防相关病变的关系。方法：对138例T2DM患者（其中单纯DM33例，DM慢性并发症105例）、38例糖耐量低减（IGT）和43例正常对照组进行血糖、胰岛素和血压测定，计算HOMA－IR、HOMA－IS、IAI和体重指数，分析其在DM三级预防相关病变中的变化。结果：按对照组、IGT组、单纯DM组和DM并发症组的次序比较，除IGT组的空腹血糖与对照组差异无显著性外，其余各组空腹血糖、餐后2h血糖和HOMA－IR水平依次增高，IAI指标依次降低，组间差异有显著性（P均＜0．01）。HOMA－IS在DM两组均低于正常对照组和IGT组，DM并发症组又低于单纯DM组（P＜0．01）。相关分析表明：IGT组HOMA－IR与体重指数、空腹血糖、餐后2h血糖、FINS呈正相关；DM患者的HOMA－IR与空腹血糖、餐后2h血糖和DM病程呈正相关（P＜0．01）。结论：胰岛素抵抗贯穿于T2DM的全过程，且程度越来越重。减轻胰岛素抵抗必须贯穿于T2DM三级预防的始终。

Study on Relationship between Insulin-Resistance and Triple-Prevention of Diabetes

To investigate the influence of the insulin resistance associated with triple prevention of type 2 diabetes (T2DM.). Blood glucose,insulin and blood pressure of 138 patients with T2DM (including 33 cases without complication and 105 cases with complication), 38 cases with impaired glucose tolerance (IGT) and 43 cases of normal control were observed The parameters such as FPG, FINS, 2 hPG, 2 hINS,SBP,DBP,BMI,HOMA IR,HOMA IS and IAI were observed and analyzed Except of the level of FPG in IGT group, the levels of FPG, 2 hPG and HOMA IR in other groups increased while the level of IAI decreased gradually, there were significant differences among the test groups (P<0 01) The levels of HOMA IS were significantly lower in T2DM groups than control and IGT groups, and significantly lower in DM with complication group than DM without complication group(P<0 01) Correlation analysis showed that HOMA IR was positively correlated with BMI, FPG, 2hPG, FINS in IGT group and the HOMA IR was positively correlated with FPG, 2hPG in the T2DM Conclusion] Insulin resistance plays an important role in the progress of the T2DM and this influence is more distinct with the progress of the diseases