高甘油三酯血症对2型糖尿病胰岛素抵抗的影响

目的：探讨2型糖尿病高甘油三脂血症与胰岛素抵抗（IR）的关系。方法：65倒2型糖尿病伴高甘油三酯（TG）血症。低密度脂蛋白胆固醇（LDL-C）升高、高密度脂蛋白胆固醇（HDL-C）降低的患者，随机分为治疗组（34例）和对照组（31例）。两组同时给予糖尿病饮食＋运动和口服降糖药，治疗组同时给予微粒化力平之0．2QD治疗12周。于治疗前后测定血腊、空腹血糖、空腹血胰岛素水平。结果：治疗前两组IAI明显降低且与TG、LDL-C、Lp（a）呈明显负相关。与HDL-C呈正相关，P〈0．05。两组治疗后血糖均明显下降，治疗组血TG下降28％，LDL-C下降25％，Lp（a）下降45％，HDL-C升高24％，胰岛敏感指数IAI显著提高（P〈0．05）；对照组IAI无显著变化。结论：脂代谢异常与IR有明显的关系，2型糖尿病调脂治疗可明显改善IR。

Effect of Hypertriglyceridemia on Insulin Resistance in Patients with Type 2 Diabetes Mellitus

Objectives:To investigate effect of hypertriglyceridemia on insulin resistance in the patients with type 2 diabetes.Methods:65 patients with type 2 diabetes complicated with hypertriglyceride(TG),or high low density lipoprotein(LDL),or Lp(a)and low high density lipoprotein(HDL) were randomly divided into the treatment group(n=31)and the control group(n=34).All patients were treated with diabetic diet and oral hypo Agents.At the same time,the treatment group was treated with lipanthyl orally for 12 weeks.The levels of serum lipids,fasting blood-glucose,fasting insulin levels were measured and compared before and after the treatment.Results:Before the treatment,IAI was lower in the both groups.It was negatively correlated with TG,LDL-c and Lp(a) and positively correlated with HDL-c(P<0.05).After the treatment,the levels of blood-glucose in the both groups obviously decreased.The levels of TG,LDL-c and Lp(a) decreased by 28%,25% and 45% respectively(P<0.01),but HDL-c increased by 24% in the treatment group(P<0.01).The insulin activity index(IAI) significantly increased (P<0.05).While there were not changes for lipids level and IAI in the control group.Conclusions.Hypertriglyceridemia was correlated with insulin resistance and the treatment of reducing lipids could significantly improve insulin sensitivity of patients with 2 diabetes mellitus.