糖尿病合并冠心病患者红细胞膜脂肪酸成分改变与胰岛素抵抗

我们采用高效液相色谱（PHLC）和荧光偏振技术测定了2型糖尿病合并冠心病病人红细胞膜脂肪酸成分和膜微粘度，并分析了脂肪酸成分、膜流动性和胰岛素敏感指数（ISI）与冠心病发生的关系。结果表明糖尿病人红细胞膜花生四烯酸（AA，C20：4）含量及组成明显低于对照组，而伴冠心病组AA含量又低于单纯糖尿病组，且其总脂肪酸含量明显低于对照组。两组病人膜微粘度明显高于对照，而冠心病组又明显高于单纯糖尿病组。糖尿病人红细胞膜AA含量与膜微粘度呈负相关，与ISI呈正相关，膜微粘度与ISI呈负相关。AA含量，微粘度和ISI均与冠心病的发生有关。提示糖尿病人冠心病的发生、发展与其脂肪酸代谢紊乱有关。

Alteration of fatty acid components and insulin resistance of red cell membrane in diabetic patients with coronary heart disease

The fatty acid components and microviscosity of erythrocyte membrane in 39 type 2 diabetic patients with and without coronary heart disease(CHD) were examined by high performance liquid chromatography (HPLC) and fluorescence polarization teachnique, and their relationship with insulin sensitivity index (ISI) and CHD were analyzed. The results showed that contents and composition of erythrocyte membrane arachidonic acid (AA,C 20:4 )were significantly lower in type 2 diabetic patients with or without CHD than those in control subjects ( P <0.01 and P <0.05). The total fatty acids contents were also significantly lower in patients with CHD than those in normal subjects ( P <0.05). In patients with or without CHD, erythrocyte membrane microviscosity was significantly increased as compared with the controls ( P <0.01 and P <0.05), and it was higher in diabetics with CHD than those without CHD ( P <0.05). AA contents of erythrocyte membrane was negatively correlated with microviscosity and positively correlated with insulin sensitivity index (ISI), while the microviscosities were negatively correlated with ISI in diabetics. AA, linoleic acid contents, microviscosity of erythrocyte membrane and ISI were all correlated with the incidence of CHD in diabetics. In diabetic patients, the fatty acid metabolic abnormality could cause the alterations of functions, structures and fluidity of erythrocyte membrane, thus may contributing to increased IRS and might be related to the incidence of CHD.