老年2型糖尿病患者空腹胰岛素及C肽水平与血脂异常的相关分析

目的观察老年2型糖尿病患者空腹胰岛素、C肽和血脂之间的相互关系。方法用电化学发光免疫法、放射免疫法和酶法分别测定30例老年糖尿病患者空腹血清中的胰岛素、C肽和血脂水平，并与10例健康老年人的相应指标作对比，分析其间相关性。结果（1）老年糖尿病组的空腹胰岛素明显高于对照组（P〈0．05），但C肽水平明显低于对照组（P〈0．05）；（2）老年糖尿病组空腹HDL-C及APOA1明显低于对照组，其中TG与胰岛素呈明显正相关（r=0．541，P〈0．01），HDL-C与胰岛素明显负相关（r=-0．413，P〈0．05），HDL-C与C肽明显正相关（r=0．374，P〈0．05）。对照组血脂各项指标与胰岛素及C肽均不相关。结论老年2型糖尿病患者中存在高胰岛素低C肽分离现象，并与该人群中血脂代谢紊乱相关，提示胰岛素抵抗和C肽的代谢异常可能是糖尿病患者血脂异常的主要原因之一。

Correlation analysis of fasting serum insulin, C peptide and dyslipidemia in the senior with type 2 diabetes mellitus

Objective To study the correlations between serum insulin, C peptide and dyslipidemia in the senior with type 2 diabetes mellitus (T2DM). Methods Electrochemiluminescence immunoassay, radioimmunoassay and enzymic method were used to measure the level of serum insulin, C peptide and blood lipid respectively in 30 senior patients with T2DM. The results were compared with 10 healthy seniors. to analyze the correlations. Results 1. The level of fasting insulin in the senior T2DM group was significantly higher than control group (P<0. 05), while the level of C peptide was lower than control group distinctly (P<0. 05). 2. The level of fasting HDL-C and APOA1 in the senior T2DM group were significantly lower than control group. The results showed positive correlation between TG and serum insulin (r=0. 541, P<0. 01), and between HDL-C and C peptide (r=0. 374, P< 0. 05) in the senior T2DM group. Negative correlation were also observed between HDL-C and serum insulin (r=-0. 413,P<0. 05) in the senior T2DM group. There were no correlation between serum insulin, C peptide and blood lipid in control group. Conclusions Hyperinsulinemia with low C peptide level may exist in the senior patients with T2DM and it may associate with dyslipidemia. This study suggests that insulin resistance and the abnormal metabolism of C peptide may play a key role in dysli-pidenia in T2DM patients.