胰岛素抵抗对主动脉根部顺应性的影响及机制初步探讨

目的探讨胰岛素抵抗对主动脉根部顺应性的影响及其初步机制。方法选择常规体检诊断为空腹血糖调节受损患者42例（IFG组）及糖耐量异常患者40例（IGT组），并选取性别、年龄匹配的健康体检者40名（对照组）作为对照。用食管超声检测主动脉根部扩张度（D值）和僵硬度（B值），并用HOMA法计算胰岛素抵抗指数（HOMA—IR）。结果IGT组D值较对照组明显降低，B值明显升高，其差异有统计学意义（P均〈0．01），IFG组D值的降低和B值的升高没有统计学意义。IFG组和IGT组的HOMA—IR水平较对照组明显升高（P均〈0．01）。直线相关分析显示，D值与HOMA—IR值呈明显负相关（r=-0．587，P〈0．01），B值与HOMA—IR值呈明显正相关（r=0．587，P〈0．01）。结论糖尿病前期（包括IFG和IGT）已存在主动脉根部顺应性的减退，其机制可能与胰岛素抵抗有关。

The impact of insulin resistance to the aortic root compliance and the preliminary study of its mechanism

Objective To study the impact of the insulin resistance to the aortic root compliance and to investigate the mechanism of them. Methods 42 patients diagnosed impaired fasting glycaemia （IFG team） in the regular body check and 40 patients diagnosed impaired glucose tolerance （IGT team） were enrolled into the study, also another 40 healthy people served as control （control team ）. The transesophageal echocardiography was used to detect the dilation （D value ） and the stiffness（ 3 value） of the aortic root, and HOMA method were used to calculate the insulin resistance （IR） index. Results As contrasted to the control team, the IGT team show a decreased D value 2.85±0.79（ 10^-6 cm^2/dyn） vs 3.45±0.84（ 10^-6 cm^2/dyn）,P〈0.01 ] and a elevated 3 value（5.13±2.12 vs 3.67±1.75,P〈0.01 ）,there were a decreasing trend in D and a increasing trend in β value in the IFG team compared to control team, but did not reach the statistical significance. The HOMA-IR of IFG team and OGT team were significant elevated when compared to control team. There was a negative correlation between D value （r=- 0.587,P〈0.01 ） and the HOMA-IR and a positive correlation between β value and the HOMA-IR （r=-0.587,P〈 0.01 ）. Conclusion In the early stage of diabetes mellltus there is already exited impaired aortic compliance, and insulin resistance maybe one of the mechanism to explain it.