2型糖尿病胰岛素抵抗与缺血性脑卒中关系的初步探讨

目的　探讨胰岛素抵抗对 2型糖尿病缺血性脑卒中的可能发病机制。方法　将 194例 2型糖尿病患者分为缺血性脑卒中组 6 3例 ,无脑卒中组 131例 ,两组患者进行血压、血糖、血脂、糖化血红蛋白 (HbA1c)、胰岛素 (INS)及胰岛素敏感性 (ISI)等差异性比较。结果　两组间ISI、HbA1c、总胆固醇 (TC)差异有统计学意义 (P <0 .0 1) ,体重指数 (BMI)、空腹胰岛素 (FINS)、空腹血糖 (FBG) /FINS和高密度脂蛋白 胆固醇 (HDL C)差异亦有统计学意义 (P <0 .0 5 ) ;两组间糖耐量试验各时相血糖值比较差异均无统计学意义 (P >0 .0 5 ) ,而脑卒中组各时相INS均较无脑卒中组明显升高 (P <0 .0 5或 P <0 .0 1) ,尚可见两组INS峰值后移。结论　 2型糖尿病除了糖脂代谢紊乱外 ,胰岛素抵抗和代偿性高胰岛素血症可能是缺血性脑卒中的又一危险因素

Preliminary study on relationship between ischemic stroke in type 2 diabetes mellitus and insulin resistance

Objective To study the mechanism of ischemic stroke in type 2 diabetes mellitus(DM) with insulin resistance.Methods One hundred and ninety-four cases of type 2 DM were divided into DM with ischemic stroke (63 cases),DM without ischemic stroke (131 cases); further ,the patients' blood pressure,blood glucose,plasma lipid,glycosylated hemoglobin A1c (HbA 1c) ,insulin,insulin sensitive index(ISI) were compared in two gropes.Results The patient's ISI,HbA 1c,total cholesterol(TC) had high significant difference between the two groups(P< 0.01); body mass index(BMI),fast insulin(FINS),fast blood glucose(FBG)/FINS and high density lipoprotein-cholesterol(HDL-C) had significant difference(P< 0.05);the blood glucose of each phase in glucose tolerance test had not significant difference(P> 0.05),but the insulin of each phase in glucose tolerance test was significantly higher in DM with ischemic stroke than in DM without ischemic stroke (P< 0.05 or P< 0.01),and the insulin peak level delayed in both groups.Conclusion In type 2 DM,insulin resistance and compensative high insulinemia may be risk factors of ischemic stroke other than glucolipid metabolism disorder.