多重危险因素干预与胰岛素抵抗关系的临床研究

目的 探讨多重心血管危险因素综合干预与胰岛素抵抗的关系。方法 276例高血压或（和）糖尿病患者，依据HOMA—IR指数分为胰岛素抵抗（IR）组和胰岛素敏感（IS）组，观察综合干预前后两组患者相关指标达标情况。结果 （1）腹围、空腹血糖与HOMA指数的相关性最明显（P〈0．01），干预前后IR组患者空腹血糖、女性腹围达标率均显著低于IS组。（2）干预前IR组达标项数≥3项的达标率显著低于IS组（26．6％vs43．5％。P〈0．01）。干预后两组比较无统计学意义；干预前、后IR组达标项≥4项的达标率均显著低于IS组（9．7％vs19．6％，P〈0.05；12．4％vs27．6％，P〈0．01）。结论 胰岛素抵抗与腹围和空腹血糖密切相关，胰岛素抵抗更容易合并多重心血管危险因素，并影响心血管危险因素的治疗达标率。

Relationship between insulin resistance and multifactorial intervention: a follow-up study

Objective To research the relationships between insulin resistance and multifactorial intervention.Methods Two hundreds and seventy-six patients with hypertension or(and) diabetes participated the follow-up study.They were divided into 2 groups:group of insulin sensitivity(IS) and group of insulin resistance(IR).The control rates of metabolic components before and after intervention were observed in 2 groups.Results(1)The control rates of fasting glucose and female waist circumference were significantly lower in IR group than in IS group either before or after intervention.(2)The control rate of more than 3 metabolic syndrome components in IR group was significantly lower than in IS group before intervention(26.6% vs 43.5%,P<0.05),whereas the difference disappeared after intervention(41.6%vs53.3%,P>0.05);the control rate of more than 4 metabolic syndrome components in IR group was also lower than IS group before intervention(9.7%vs19.6%,P<0.05),and the difference became more significant after intervention(12.4% vs 27.6%,P<0.01).Conclusion(1)Insulin resistance is closely correlated with waist circumference and fasting blood glucose.(2)Patients with insulin resistance tend to cluster cardiovascular risk factors,and insulin resistance might affect the control of these risk factors.