维持性血液透析患者血脂变化和胰岛素抵抗的相关分析

目的 通过对48例维持性血液透析患者空腹血糖、血清胰岛素和血脂各项指标的观察,计算胰岛素抵抗指数和胰岛素敏感指数,评价胰岛素抵抗情况.方法 选取我科维持性血液透析患者48例(观察组),同时选取30名健康体检者(对照组)作为正常对照,测定两组受试者的血糖、糖化血红蛋白、血清胰岛素、尿素氮、肌酐、尿酸、血脂指标,计算胰岛素抵抗指数和胰岛素敏感指数.结果 维持性血液透析患者的血糖、血清胰岛素、糖化血红蛋白、胰岛素抵抗指数水平升高,胆固醇、高密度脂蛋白、低密度脂蛋白与对照组比较差异有统计学意义(P＜0.05),其中胆固醇与血糖呈负相关(r=-0.3482,P＜0.05);高密度脂蛋白与血清胰岛素呈负相关(r=-0.2603,P＜0.05);低密度脂蛋白与血糖呈负相关(r=-0.3289,P＜0.05),而对照组仅甘油三酯与血糖、胰岛素抵抗指数呈正相关(r分别=0.371,0.368,P均＜0.05).结论 维持性血液透析患者中存在脂代谢紊乱,可能参与胰岛素抵抗.

The variation of lipid in maintenance hemodialysis and the relationship with insulin resistance

Objective To observe the fasting plasma glucose,serum insulin and lipid level in maintenance hemodialysis calculate the insulin resistance index(HOMA-IR) and the insulin sensitivity index (ISI) to evaluate the relationshion with insulin resistance( IR) ,to carry out correlation analysis with the corresponding index of 30 health examinations.Methods Forty-eight maintenance hemodialysis patients and 30 healthy volunteers were included in this study.Serum glucose,glycosylated hemoglobin,serum insulinum urea nitroge,creatinine,uric acid and lipid index were measured,and analysized the relationship of them.Results Serum glucose,glycusylated hemoglobin,serum insulinum HOMA-IR were higher in patients than in controls,total cholesterol,high density lipid protein and low density lipid protein were lower in controls,total cholesterol was negative correlated with fasting plasma glucose ( r=-0.3482,P ＜ 0.05).Hige density lipid protein was negative correlated with serum insulin ( r=-0.2603,P＜0.05).low density lipid protein was negative correlated with fasting plasma glucose ( r=-0.3289,P＜0.05),triglyceride was positively correlated with fasting plasma glucose and HOMA-IR( r=0.371,0.368,all P＜0.05).Conclusion Lipid metabolic disorder was exidted in maintenance hemodialysis patients,HOMA-IR maybe participate in them.