冠心病患者胰岛素抵抗与血脂、载脂蛋白异常的关系

目的探讨冠心病(CHD)患者胰岛素抵抗(IR)与血脂、载脂蛋白异常的关系。方法以空腹胰岛素(FIns)／空腹葡萄糖(FBG)比值和口服葡萄糖负荷之后胰岛素曲线下面积(RIAUC)／葡萄糖曲线下面积(GAUC)比值作为IR指标，与空腹血脂、载脂蛋白进行直线相关分析。结果与正常对照组比较，冠心病组血清甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、载脂蛋白B(apoB)；FIns／FBG比值以及RIAUC、GAUC和RIAUC／GAUC比值均显著增加(P<0．05～0．001)，高密度脂蛋白胆固醇(HDL-C)，HDL2-C，apoAI及apoAI／apoB比值均显著降低(P<0．05～0．001)；冠心病组FIns/FBG比值和RIAUC／FBG比值均分别与TG、LDL-C和apoB呈正相关(P<0．05～0．01)，与HDL2-C、apoAI和apoAI／apoB比值呈负相关(P<0．05～0．001)，正常对照组与上述指标间则无相关(P>0．05)。结论CHD患者IR与血脂、载脂蛋白异常密切相关。

The clinic study on the relationship between insulin resistance and dyslipidemia in coronary heart disease

Objective:To study the relationship between insulin resistance and dyslipidemia in coronary heart disease. Method: Linear correlation was analyzed between IR indices ( ratio of fasting insulin/fasting glucose and ratio of area under insulin curve/area under glucose curve after oral glucose tolerance test) and fasting blood lipids of CHD and normal controls. Result :Compared with normal control group,serum triglycerides (TG), low density lipoprotein cholesterol (LDL-C), apolipoprotein B (apoB), fasting insulin and the ratio of fasting insulin / fasting glucose as well as area under insulin curve, area under glucose curve, and the ratio of area under insulin curve /area under glulcose curve were significently increased (P ＜0.05～0. 001),and high density lipoprotein cholesterol (HDL-C), HDL2-C, apolipoprotein AI (apoAI) and the ratio of apoAI/apoB were significently decreased ( P ＜0.05～0. 001) in CHD group. The ratio of fasting insulin /fasting glucose and the ratio of area under insulin curve /area under glucose curve positively correlated with TG, LDL-C and apoB (P <0.05 ～ 0. 01), and negatively correlated with HDL2-C, apoAI and the ratio of apoAI/apoB (P ＜ 0.05 ～ 0. 001) respectively in CHD group. However there were no such correlations between the afore said indices in the normal control group ( P ＞0.05). Conclusion:Dyslipidemia is closely correlated with IR in CHD patients.