2型糖尿病血管并发症与胰岛素抵抗及血脂异常的关系

目的探讨2型糖尿病血管并发症与胰岛素抵抗及血脂异常之间的关系.方法测定99例2型糖尿病患者空腹血糖(FPG)、空腹胰岛素(FINS)、糖基化血红蛋白(HbA1c)、血脂、尿白蛋白排泄率(UAER)等,按血管并发症的有无分组.结果① 2型糖尿病血管病变组与无血管病变组比较,胰岛素抵抗指数(IRI)、血压、HbA1c、TCH、TG、LDL-C、VLDL-C、ApoB显著升高(P<0.05至P<0.001),HDL-C、ApoA显著降低(P分别<0.001,0.005).②胰岛素抵抗指数(IRI)与收缩压(SBP)、TCH、LDL-C、ApoB、尿白蛋白排泄率(UAER)呈正相关(r、P分别为0.333、 P<0.001,0.231、P<0.005,0.386、P<0.001, 0.467、P<0.001,0.427、P<0.001).结论① 2型糖尿病血管病变组比无血管病变组存在更严重的胰岛素抵抗和脂代谢紊乱.②胰岛素抵抗与血脂紊乱、血压及尿白蛋白排泄率密切相关.

Relationship between type 2 diabetic vasculopathy and insulin resistance lipids disorder

Objective To investigate the relationship between type 2 diabetic vasculopathy and insulin resistance, lipids disorder. Methods The concentrations of fasting plasma glucose,fasting insulin,glycosylated hemoglobin,blood lipids and urinary albumin excretion rate were determined in 99 patients with type 2 diabetes. The patients were divided into groups by type 2 diabetic patients with or without vasculopathy.Results The levels of insulin resistance index,blood pressure, glycosylated hemoglobin, TCH,TG,LDL-C,VLDL-C and ApoB in type 2 biabetic patients with vasculopathy were significantly higher than the ones without vasculopathy(P<0.05 to 0.001 respectively);the levels of HDL-C,ApoA in patients with vasculopathy were significantly lower than that in patients without vasculopathy(P<0.001,0.005 respectively).IRI was positively corrected with SBP,TCH,LDL-C,ApoB,UAER,(r=0.333,P<0.001, 0.231, P<0.005, 0.386, P<0.001, 0.467,P<0.001, 0.427,P<0.001 respectively) and negatively corrected with HDL-C , ApoA(r=-0.426,P<0.001, -0.279,P<0.01 respectively). Conclusion Insulin resistance and lipids disorder in type 2 diabetic patients with vasculopathy are more severe than the ones in patients without vasculopathy. IRI is closely corrected with lipids disorder, blood pressure and UAER.