2型糖尿病患者空腹血清真胰岛素水平和胰岛素抵抗与血脂的关系  

A study on the relation of serum fasting true insulin level and insulin resistance with serum lipids in patients with type 2 diabetes mellitus

作　　者：甘宇[1] 张国峰[2] 李宏革[3] 张锦[2] 郑长虹[1] 孟馨[2] 彭阳[2] 

机构地区：[1]沈阳市第七人民医院内分泌科,110003 [2]中国医科大学附属第一临床医院内分泌科 [3]沈阳医学院卫生统计教研室

出　　处：《中华糖尿病杂志（1006-6187）》2004年第6期402-404,共3页

基　　金：辽宁省自然科学基金资助项目 (9910 5 0 0 3 0 2 )

摘　　要：目的　探讨 2型糖尿病 (T2DM )患者空腹血清真胰岛素水平、胰岛素抵抗与血脂的关系。　方法　应用BA ELISA法测定正常糖耐量 (NC)组 96例、T2DM组 132例和T2DM伴原发性高血压 (T2DM +EH)组 14 8例的空腹血清真胰岛素 (TI)水平 ,酶法检测血脂 ,计算胰岛素抵抗指数(HOMA IR)、β细胞功能指数 (HOMA β)。 　结果　T2DM组及T2DM +EH组的甘油三酯 (TG)、HOMA IR高于NC组 ,高密度脂蛋白胆固醇 (HDL C)和HOMA β低于NC组 ,差异均有显著意义 (P<0 0 5 )。T2DM +EH组HOMA IR高于T2DM组 ,差异有显著意义 (P <0 0 5 )。T2DM组及T2DM+EH组的TG与TI、HOMA IR呈正相关 (P <0 0 1) ,HDL C与TI、HOMA IR呈负相关 (P <0 0 5 )。　结论　T2DM患者空腹血清TI水平与脂代谢异常相关 ,血清TI水平的升高和 (或 )IR的加重均会引起TG升高和HDL C降低。IR与脂代谢异常及高血压的关系较高TI血症更密切。Objective To explore the relationship of serum fasting true insulin (TI) level and insulin resistance (IR) with lipids in patients with type 2 diabetes(T2DM) Methods The fasting TI was determined with BA ELISA method, blood lipids and blood glucose(PG) with an enzyme method in 96 subjects with NC, 132 subjects with T2DM and 148 subjects with T2DM accompanying primary hypertension(T2DM+EH), who did not undergo any antidyslipidemia treatment for a month and antihypertensive treatment for two weeks On the basis of FPG and TI, insulin secretion function (HOMA β) and IR level (HOMA IR) were calculated Results TG and HOMA IR in both T2DM and T2DM+EH groups were significantly higher than those in NC group ( P <0 01) HDL C, HOMA β in T2DM and T2DM+EH groups were significantly lower than those in NC group ( P <0 05) HOMA IR in T2DM+EH group was significantly higher than that in T2DM group HOMA β in T2DM+EH group was higher than that in T2DM group, but the difference was not significant TG had statistically significant positive correlation with TI and HOMA IR( P <0 01), HDL C had statistically negative correlation with TI and HOMA IR ( P <0 05) in both T2DM and T2DM+EH Conclusion Serum true insulin level and insulin resistance are associated with dyslipidemia in type 2 diabetes The elevated true insulin and/or serious insulin resistance will elevate TG and decrease HDL C Insulin resistance is more associated with dyslipidemia than truly hyperinsulinemia

关 键 词：T2DM 空腹 血清 EH 真胰岛素 血脂 患者 IR HDL-C 胰岛素抵抗 

分 类 号：R587.1[医药卫生—内分泌]