2型糖尿病合并痛风患者胰岛素抵抗与红细胞膜胰岛素受体的关系  

The relationship between insulin resistance and insulin receptor on erythrocyte membrane in patients with gout and type 2 diabetes mellitus

作　　者：于健[1] 冼苏[2] 苏珂[1] 龙艳[1] 蔡豪斌[3] 肖福英[3] 唐灵[1] 彭鹰[1] 胡永玲[1] 林枫[1] 刘健翔[3] 

机构地区：[1]桂林医学院附属医院内分泌科,541001 [2]广西医科大学第一附属医院内分泌科 [3]桂林医学院生物研究所

出　　处：《中华糖尿病杂志（1006-6187）》2004年第4期232-234,共3页

基　　金：广西卫生厅医药卫生科研课题基金资助项目(Z2 0 0 10 62 )

摘　　要：目的　探讨 2型糖尿病 (T2DM )合并痛风患者胰岛素抵抗 (IR)与红细胞膜胰岛素受体之间的关系。　方法　 30例T2DM合并痛风患者 (T2DM +Gout)、30例无痛风的T2DM患者、30例痛风患者 (Gout)、2 6名正常人作对照 (NC) ,进行空腹血糖 (FPG)、胰岛素 (FIns)及口服葡萄糖耐量试验(OGTT)后 2h血糖 (2hPG)、胰岛素 (2hIns)及胆固醇 (TC)、甘油三酯 (TG)、高密度脂蛋白(HDL)、低密度脂蛋白 (LDL)、血尿酸 (UA)的测定 ,同时检测高、低亲和力红细胞膜胰岛素受体数目(R1、R2 )和高、低亲和力常数 (K1、K2 ) ,并以稳态模型 (HOMA)计算胰岛素抵抗指数 (HOMA IR)为应变量 ,FIns、年龄、体质指数 (BMI)、TG、TC、LDL、HDL、收缩压 (SBP)、舒张压 (DBP)、UA、R1、R2 、K1、K2 为自变量 ,进行多元逐步回归分析 ,分析T2DM合并痛风患者IR与红细胞膜胰岛素受体变化的关系。　结果　T2DM合并痛风较无痛风的T2DM患者LDL明显升高 ,HDL降低 ,HOMA IR显著升高 ,且R1、R2 、K2 明显减少 ,有统计学意义。多元逐步回归分析结果示 :在α =0 0 5水平 ,进入回归方程的因素有FIns、BMI、R2 、K1,有统计学意义。　结论　T2DM合并痛风较无痛风的T2DM患者存在明显IR ,且与红细胞膜胰岛素受体数目和亲和力密切相关。Objective To investigate the relationship between insulin resistance and insulin receptors on erythrocyte membrane in patient s with type 2 diabetes mellitus and gout. Methods The levels of glucose and insulin at fasting and 2 hours OGTT, TC, TG, HDL, LDL, UA and i nsulin receptor number and its binding affinity on erythrocyte were determin ed in patients groups of DM+gout, DM, gout, and 26 control subjects. A multipl e stepwise regression analysis was used on HOMA-IR as the dependent variabl e, and the levels of FIns, age, BMI, TG, TC, LDL, HDL, SBP, DBP, UA, R 1, R 2 , K 1, K 2 as the independent variables. Results HDL, R 1, R 2, K 2 were significantly lower and LDL, HOMA-IR were significantly h igher in the DM+gout patients than those in DM patients. In the group of DM +gout, a multiple stepwise regression analysis indicated that FIns, BMI, R 2, and K 1 were independent factors that affect HOMA-IR. Conclu sion There is higher insulin resistance in the DM+ gout than that i n DM.The reduction of insulin receptor numher and binding affinity may play an important role in pathogensis of insulin resistance.

关 键 词：2型糖尿病 痛风 胰岛素抵抗 红细胞膜胰岛素受体 并发症 

分 类 号：R587.1[医药卫生—内分泌] R589.7[医药卫生—内科学]