慢性阻塞性肺疾病患者胰岛素抵抗的研究

目的 探讨慢性阻塞性肺疾病(COPD)与胰岛素抵抗(IR)的相关性及发生机制.方法 对80例COPD急性加重期患者(急性加重期组),34例稳定期患者(稳定期组)和26名健康体检者(正常对照组)进行肺功能、空腹血糖(FBG)、空腹胰岛素(FINS)、空腹血清C肽(FCP)、C-反应蛋白(CRP)、甘油三脂(TG)、总胆固醇(TC)、尿微量白蛋白(MALB)测定,并计算IR指数(HOMA-IRI).结果 与正常对照组比较,急性加重期组、稳定期组的CRP、TG、MALB、FCP、FBG、FINS、HOMA-IRI、IR发生率升高(P＜0.01);随着COPD病情加重,FCP、FBG、FINS、HOMAIRI、IR发生率也随之增高(P＜0.01或＜0.05).结论 COPD患者存在IR,发生IR的风险与病情严重程度有潜在关系.

Relationship between insulin resistance and chronic obstructive pulmonary disease

Objective To investigate the correlation of chronic obstructive pulmonary disease（COPD） with insulin resistance and its underlying mechanisms.Methods Pulmonary function,fasting blood glucose（FBG）,fasting insulin（FINS）,fasting C-protein （FCP）,C-reactive protein （CRP）,triglyeeride （TG）,total cholesterol （TC） and urine microalbumin（MALB） were determined in 80 patients with acute exacerbations of COPD,34 patients with stable COPD and 26 healthy subjects.Then,the insulin resistance index（IRI） was assessed by Homeostasis Model Assessment for IRI（HOMA-IRI）.Results CRP,TG,MALB,FCP,FBG,FINS,HOMA-IRI and the incidence of IR in patients with acute exacerbations of COPD and patients with stable COPD were significantly higher than those in the healthy subjects （P ＜0.01）.Furthermore,the levels of FCP,FBG,FINS,HOMA-IRI and the incidence of IR increased with the severity of COPD（P ＜0.01 or ＜0.05）.Conclusion High incidence of IR exists in patients with COPD.The risk of IR in patients with COPD is correlated with the severity of COPD.