胰岛素抵抗与血脂在冠心病中的作用与关系

目的 :为探讨冠心病患者的胰岛素抵抗与血脂水平的关系 ,对 80例 (女性均为绝经 1年以上者 )经选择性冠状动脉造影证实的冠心病患者 (男 4 2例 ,女 38例 )和 70例正常对照组 (男 36例 ,女 34例 )进行对比研究。方法 :采用氧化酶法、放射免疫法同时观察空腹及餐后两小时血糖、胰岛素及胰岛素敏感指数 (ISI)的变化。用酶法观测空腹总胆固醇 (TC)、甘油三酯 (TG)、高密度脂蛋白 (HDL)及低密度脂蛋白胆固醇 (LDL -C)的变化。结果 :男性冠心病组与女性冠心病组空腹血糖均无明显差异 ,空腹及糖负荷后的胰岛素较正常对照组升高 (P <0 .0 5及P <0 .0 1) ;胰岛素敏感指数明显高于对照组 (P <0 .0 1) ;餐后 2h血糖高于对照组 (P <0 .0 1)。男性冠心病患者TC、TG、LDL -C亦均显著高于对照组 (P <0 .0 1) ,HDL显著低于对照组 (P <0 .0 5 ) ;女性冠心病患者TC、TG、LDL -C亦均高于对照组 (P <0 .0 5 ) ,HDL低于对照组 (P <0 .0 5 )。结论 :与正常对照组相比 ,无论男性或女性冠心病患者均存在高胰岛素血症、胰岛素抵抗、血脂代谢异常。它们相互影响 ,共同参与冠心病的发生与发展

ROLE AND RELATIONSHIP OF INSULIN RESISTANCE AND SERUM LIPID IN PATIENTS WITH CORONARY HEART DISEASE

Objective:In order to find the changes of serum lipid in patients with coronary heart disease (CHD) and the roles and relationship between serum lipid and insulin resistance (IR), eighty patients (forty-two males and thirty-eight postmenopausal females) with CHD confirmed by coronary artery angiography and seventy controls (thirty-six males and thirty-four postmenopausal females) were compared. Methods:Plasma glucose was measured using exidase, insulin with radioimmunoassay at the same time. Plasma total cholesterol (TC), triglycerides (TG), low density lipoprotein cholesterol (LDL-C) and high density lipoprotein were estimated by enzymatic method. Results:In men and women with coronary heart disease (CHD) fast blood glucose was no significant difference. But fasting and at two hours concentration of insulin was higher in patients with CHD than that in controls ( P <0.01). The level of blood glucose at two hours was significantly higher than controls ( P <0.05).Compared with controls, insulin sensitivity index ISI was increased in patients ( P <0.01).TC?TG and LDL-C were significantly increased in male patients ( P <0.01),but HDL was decreased ( P <0.01); TC?TG and LDL-C were also increased in female patients ( P <0.05),but HDL was decreased ( P <0.05). Conclusions:Compared with controls, all the patients with CHD have hyperinsulinemia insulin resistance and adverse serum lipid profile. It is suggested that the interaction among the things above might be involved in the development of CHD.