肥胖相关性肾病患者胰岛素抵抗状态评估指标的分析  

Assessment of insulin resistance in patients with obesity related glomerulopathy

作　　者：陈燕 刘志红[2] 陈慧梅[2] 贾忠辉[2] 王庆文[2] 黎磊石[2] 

机构地区：[1]南京大学医学院临床学院 [2]南京军区南京总医院解放军肾脏病研究所,南京210002

出　　处：《肾脏病与透析肾移植杂志》2005年第5期423-426,共4页Chinese Journal of Nephrology,Dialysis & Transplantation

摘　　要：目的:以胰岛素抵抗指数(HOMA-IR)作为标准评价肥胖相关性肾病(ORG)患者胰岛素抵抗(IR)状态,并探讨血脂评估ORG患者个体IR的价值。方法:选取经临床和肾脏病理证实的ORG患者36例,健康体检的正常人266例作为对照(空腹血糖<6·1mmol/L,且BMI<25kg/m2),测定两组人群的空腹血糖、胰岛素、总胆固醇(Chol)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)水平,计算HOMA-IR以评价ORG患者的IR状态。分析ORG人群的Chol、TG、HDL-C、LDL-C、TG/HDL-C比值与HOMA-IR的相关关系。结果:ORG患者的HOMA-IR平均值为6·32±4·11,显著高于对照组(1·98±0·89,P<0·001)。ORG的Chol、TG、TG/HDL-C比值较对照组显著升高,HDL-C显著降低(P<0·01),LDL-C升高(P<0·05)。其中以TG、TG/HDL-C比值升高更明显。Chol、TG、HDL-C、LDL-C、TG/HDL-C比值与HOMA-IR相关系数分别为0·195、0·122、-0·045、-0·019、0·143,均无统计学差异(P>0·05)。结论:HOMA-IR作为评估IR的指标同样适用于ORG患者。虽然血脂水平也被用于IR的评估,但对于ORG患者并不是理想指标。Objective：To determine the insulin resistance in patients with obesity related glomerulopathy （ORG） assessed by Homeostasis model assessment of insulin resistance （HOMA-IR） , and evaluate the level of serum lipids to identify the ORG individuals who are insulin resistant. Methodology：Thirty-six patients with ORG were included in this study. Two hundred and sixty-six healthy people served as controls （fasting glucose 〈 6. 1 mmol/L, BMI 〈 25 kg/m^2）. The concentrations of fasting glucose, insulin, total cholesterol, triglyceride, high-density lipoprotein cholesterol and lowdensity lipoprotein cholesterol were measured in all subjects by routine methods. HOMA-IR was calculated for the marker of insulin resistance. The index of HOMA-IR and the level of serum lipids was compared between two groups. The person correlative coefficients were used to evaluate the correlations between the lipid and HOMA-IR in patients with ORG. Resuits：The index of HOMA-IR in ORG patients was significant higher than that in controls （6.32 ±4. 11 and 1.98 ±0. 89 respectively,P 〈0. 001 ）. The patients with ORG, compared to controls, had higher level of total plasma cholesterol, triglyceride, the ratio of triglyceride to high-density lipoprotein cholesterol （P 〈 0. 01 ） , and higher low-density lipoprotein cholesterol （P 〈0. 05 ）, but lower high-density lipoprotein cholesterol （P 〈 0. 01 ）. Of these, the changes in triglyceride and the ratio of triglyceride to high-density lipoprotein cholesterol were greater than that in others. The person correlative coefficients of total plasma cholesterol, triglyceride, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol and the ratio of triglyceride to high-density lipoprotein cholesterol to HOMA-IR were 0. 195, 0. 122, -0. 045, -0. 019, and 0. 143, respectively, which had no significantly difference. Conclusion： HOMA-IR can be used to identify insulin resistance in patients with ORG, but the level of lipids cannot be, although it is

关 键 词：肥胖相关性肾病 胰岛素抵抗 评估 血脂 胰岛素抵抗状态 肥胖相关性肾病 肾病患者 TG/HDL-C比值 胰岛素抵抗(IR) 胆固醇(Chol) 评估指标 HOMA-IR 高密度脂蛋白胆固醇 

分 类 号：R692[医药卫生—泌尿科学]