糖耐量正常的冠心病患者胰岛素抵抗与冠脉病变程度的关系

目的观察正常糖耐量的冠心病患者中冠脉病变与胰岛素抵抗的关系。方法回顾性分析本院行冠脉造影的129例冠心病患者的临床资料,根据Gensini积分评估冠脉病变的严重程度,采用HOMA-IR来评估机体的胰岛素抵抗,最后探讨两者的关系。结果单因素相关分析表明胰岛素抵抗组的冠脉病变程度明显高于胰岛素敏感组,且随着胰岛素抵抗的加重,冠脉病变程度和支数随之加重;多因素相关分析表明,胰岛素抵抗与Gensini积分、冠脉有无病变显著相关。结论在糖耐量正常的冠心病患者中,血糖、糖化血红蛋白可能不是冠脉病变的危险因素,而胰岛素抵抗可能是冠脉病变发生发展最强的危险因素,在冠心病的防治时有必要对正常糖耐量患者的胰岛素抵抗进行有效的干预。

Correlation of insulin resistance with coronary artery lesion in patients of coronary heart disease with normal glucose tolerance

Objective To investigate the correlation of insulin resistance with the severity of coronary artery lesions in patients of coronary artery disease(CAD) with normal glucose tolerance(IR). Methods Angiography of coronary arteries was performed in 129 CAD patients who had normal glucose tolerance.Gensini score was used to determine the severity of coronary artery lesions.Insulin resistance was assessed by homeostasis model assessment.The correlation of insulin resistance and coronary angiographic findings were analyzed.Results The severity of coronary artery lesions were significant increased in IR group compared with that in insulin sensitive(IS) group.Insulin resistance was positively correlated with the occurrence and severity of coronary artery lesions.Conclusion In CAD patients widi normal glucose tolerance,insulin resistance may be the most important risk factor for the occurrence and development of coronary artery lesions.