糖尿病家系非糖尿病一级亲属脂代谢紊乱和胰岛素抵抗调查

背景2型糖尿病具有家族聚集性,家系非糖尿病一级亲属中存在脂代谢紊乱.目的探讨2型糖尿病家系成员血脂水平和胰岛素抵抗的相互关系.设计以糖尿病家系非糖尿病一级亲属为研究对象的回顾性病例一对照研究.单位一所大学医院内分泌科.对象本研究于1999-06/1999-11在重庆医科大学第一附属医院内分泌科完成.选择重庆地区2型糖尿病家系中非糖尿病一级亲属125例,根据血脂水平分成高脂组和血脂正常组,其中高血脂组71例,男25例,女46例;血脂正常组54例,男20例,女34例.方法对所有研究对象测量身高、体质量和血压.留取肘静脉血用于测定空腹血糖(FPG)、血清胰岛素(FINS)、C肽水平、三酰甘油(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C).主要观察指标①两组间临床变量比较;②两组间FPG、FINS、肽水平、胰岛素抵抗指数(HOMA-IR)比较.结果高血脂组空腹胰岛素水平(12.92±5.26)μU/L]显著高于血脂正常组(9.15±4.66)μU/L](t=2.17,P<0.05);评价胰岛素抵抗的HOMA-IR,高脂组(2.94±1.25)明显高于血脂正常组(2.01±0.94)(t=2.70,P<0.01);高脂组HOMA-IR和TC、TG、LDL-C呈显著正相关(r=0.34,0.78,0.42),其中TG的相关性最强(r=0.78,P<0.01);HOMA-IR和HDL-C无显著相关性(P>0.05).结论糖尿病高危人群中脂代谢紊乱和胰岛素抵抗有密切的关系,可能是互为因果关系,为一级康复干预提供目标人群.

Correlation between blood lipid metabolic disorder and insulin resistance in the non-diabetic first degree relatives of type 2 diabetic pedigrees

BACKGROUND: Metabolic disorder of blood lipid can be observed in the non-diabetic first-degree relatives.OBJECTIVE: To explore the relationship between the level of blood lipid and insulin resistance in members of type 2 diabetic pedigrees.DESIGN: A retrospective case control study of the non-diabetic first-degree relatives of type 2 diabetic families.SETTING: The department of endocrinology of a university hospital.PARTICIPANTS: This study was carried out in the Department of Endocrinology of the First Affiliated Hospital of Chongqing Medical College from June to November 1999. A total of 125 non-diabetic first-degree relatives of type 2 diabetic pedigrees in Chongqing were recruited and divided into hyperlipemia group and normal control group according to their blood lipid level.INTERVENTIONS: Body height, body mass and blood pressure of all the subjects were measured. Their cubital venous blood samples were also obtained for determination of the levels of fasting plasma glucose (FPG), fasting insulin(FINS), fasting C-peptide(FCP), triacylglycerol(TG), total cholesterol(TC), low-density lipoprotein-cholesterol (LDL-C), and high-density lipoprotein-cholesterol (HDL-C).homeostasis model assessment insulin resistance(HOMA-IR) between the two groups.RESULTS: The level of FINS was markedly higher in the hyperlipemia group (12.92 ±5.26) μU/L] than in the control group(9.15 ±4.66) μU/L]( t = 2. 17, P < 0.05) . HOMA-IR was also significantly higher in the hyperlipemia group (2.94 ± 1.25 ) ] than in the control group (2.01 ± 0.94) ]( t = 2.70, P < 0.01 ) . In the hyperlipemia group, HOMA-IR was positively correlated with TC, TG and LDL-C ( r = 0. 34, 0. 78, 0.42), with TG most closely correlated( r = 0. 78, P < 0. 01), while HOMA-IR had no significant relation with HDL-C ( P > 0.05).CONCLUSION: There is a close correlation between lipid metabolic disorder and insulin resistance in the high-risk diabetic group.