糖耐量减低患者胰岛素抵抗与颈动脉粥样斑块的相关性分析

目的 :探讨胰岛素抵抗 ( IR)在 IGT大血管并发症中的作用。方法 :测定 1 2 0名 IGT患者和 96名糖耐量正常 ( NGT)对照者的空腹血糖、胆固醇 ( TC)、甘油三酯 ( TG)、胰岛素及餐后 2 h血糖 ,并测量身高、体重、腰围、臀围 ,计算相对胰岛素敏感指数 ( RISI)、体重指数 ( BMI)、腰臀比 ( WHR) ,结合颈动脉多普勒超声检测结果进行对比分析。结果 :IGT组及 NGT组颈动脉粥样斑块发生率有显著性差异 ( P<0 .0 0 1 ) ,斑块面积与 RISI呈负相关 ( r=- 0 .45 ,P<0 .0 1 ) ,与餐后 2 h血糖 ( r=0 .39,P<0 .0 1 )、BMI( r=0 .48,P<0 .0 1 )及 WHR( r=0 .41 ,P<0 .0 1 )呈正相关 ,而与 TG、FBG、TC、FINS无相关性 ( P>0 .0 5 )。 IGT组患者有斑块和无斑块者之间 RISI、WHR、BMI、餐后 2 h血糖、TG之间也存在显著性差异 ( P<0 .0 1 )。结论 :胰岛素抵抗与颈动脉粥样硬化的发生密切相关 ,是 IGT患者发生大血管并发症的重要原因

INSULIN RESISTANCE (IR) AND CAROTID ARTERIOSCLEROSIS IN IMPAIRED GLUCOSE TOLERANCE(IGT)

Objective:To evaluate the effect of insulin resistance(IR) on the macrovascular complications of impaired glucose tolerance(IGT).Methods:One hundred and twenty cases of IGT and 96 cases of nomal glucose tolerance(NGT) were exammined by using carotid ultrasonography for their fasting and postprandial plasma glucose(FPG and PBG),fasting insulin (FINS),total cholesterol and triglyceride (TC and TG) and all the cases were also examined for body mass index(BMI) and waist/hip ratio (WHR).Results:Fourty eight cases with carotid cartery plaque were found in IGT patients and 5 cases in NGT( P <0 01),the plaque area had positive correlation with PBG( r =0 39, P <0 01),BMI( r =0 48, P <0 01),WHR( r= 0 41, P <0 01) and had negative correlation with relative insulin sensitivity index(RISI)( r =-0 45, P <0 01),but had no correlation with TG and TC.There were significant differences between IGT patients with and without carotid artery plaque in RISI,WHR,BMI,TG and PBG ( P <0 01).Conclusion:Our study suggests relation between IR and carotid artery atherosclerosis, and IR is a major cause of the macrovascular complications in IGT.