糖尿病血甘油三酯水平与胰岛素抵抗的关系

目的　探讨血甘油三脂 (triglycerides,TG)水平与胰岛素抵抗及糖化血红蛋白 (HbA1c)浓度的关系。 方法　对 1 0 9例 2型糖尿病 (diabetesmellitus ,DM )患者测定了血浆空腹胰岛素 (fastinsulin ,FINS)、空腹血糖 (fastserumglucose ,FBG)、HbA1c、高密度脂蛋白胆固醇 (highdensitylipoproteincholesterol,HDL -C)、血TG和血胆固醇 (choles terol,CHO)水平。并按血CHO、TG及HbA1c分组 ,同时比较组间差异与HbA1c浓度及和胰岛素敏感指数 (IAI)的关系。结果　血CHO与HbA1c和IAI之间差异无显著性 (P >0 .0 5 ) ,TG与HbA1c和IAI之间差异有显著性 (P<0 .0 0 5 )。HbA1c浓度和IAI(P <0 .0 0 5 ) ,提示高糖毒性明显增加胰岛素抵抗。结论　血TG水平升高明显影响HbA1c浓度和IAI ,影响血糖代谢并增加胰岛素抵抗 ,HbA1c浓度升高明显影响IAI ,增加胰岛素抵抗。

The Relationship between the Level of Serum Triglyceride and Insulin Resistance in Diabetes

Objective To explore the relationship between serum triglyceride and insulin resistance and the concentration of HbA1c.Methods 109 type 2 diabetic patients enrolled in the study,and their fasting plasma insulin,fasting blood glucose,hemoglobulin A1c(HbA1c),serum triglyceride and cholesterol were measured.The patients were divided according to their cholesterol,triglyceride and HbA1c.Meanwhile the difference between the groups and their relationship between HbA1c and insulin sensitivity index(IAI)were studied.Results The level of blood cholesterol did not show significant difference as compared to HbA1c ( P >0.05),and so did blood cholesterol to IAI( P >0.05).The level of TG had obvious difference as compared to HbA1c and IAI( P <0.05, P <0.005,respectively).The level of HbA1c had significant difference when compared to IAI( P <0.005),suggesting chat the toxicity of high blood glucose and hypertriglyceride increased the insulin resistance.Conclusion The increase of triglyceride can affect the concentration of HbA1c and IAI,also affect glucose metabolism and enhance insulin resistance;and the increase of HbA1c can affect IAI,and enhance insulin resistance.It is proposed that the deterioration of diabetes is closely related with glucotoxicity and dyslipidemia.It is essential to control hypertriglyceride and further to control blood glucose.These can minimize insulin resistance and protect B cell function,and thus is important to control diabetes mellitus and decrease the occurrence of long term chronic complications.