老年糖尿病患者餐后脂代谢紊乱与胰岛素敏感性的相关性研究  

Related research of aged diabetic fat supersession disorder after meal with insulin sensitiveness

作　　者：刘永煌[1] 徐丽芸[2] 郭丛兰[3] 李再平[4] 李贵芳[5] 蒋晓梅[1] 王秀容[1] 

机构地区：[1]贵州省人民医院干医科,贵州贵阳550001 [2]贵州省人民医院营养科,贵州贵阳550001 [3]贵州省人民医院肿瘤科,贵州贵阳550001 [4]贵州省人民医院核医学科,贵州贵阳550001 [5]贵州省人民医院检验科,贵州贵阳550001

出　　处：《中国现代医学杂志》2006年第5期734-736,740,共4页China Journal of Modern Medicine

摘　　要：目的探讨老年糖尿病患者餐后脂代谢紊乱与胰岛素敏感性的相关性。方法测定老年糖尿病患者胰岛素敏感指数(IAI)和胰岛素抵抗指数(IR)等两项指标作为评价胰岛素敏感性指标,并与空腹及餐后2,4,6,8h时段的总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、载脂蛋白A1(APOA1)及载脂蛋白(BAPOB)水平进行相关分析,探讨它们之间的关系。结果除餐后2h胰岛素水平外,老年糖尿病组空腹及餐后4,6,8h时段胰岛素水平明显高于对照组(P<0.05或<0.01);老年糖尿病组IR显著高于对照组(P=0.016)。老年糖尿病组及对照组IAI与IR呈显著负相关(r=-0.812,-0.985),且老年糖尿病组IAI与空腹、餐后4、6及8h的TG呈显著负相关(r=-0.433,-0.429,-0.518,-0.451),而IR与体重指数(BMI)、腰臀比值(WHR)、餐后4h及餐后6h的TG呈显著正相关(r=0.659,0.554,0.455,0.498)。多元逐步回归分析,老年糖尿病组,去除年龄、BMI及WHR因素,以IAI、IR为应变量,空腹及餐后2、4、6和8h等5个时点的血脂各项指标为自变量,其回归方程为:IAI=-0.609TG(6h)-0.385(P=0.031),IR=0.807T(G6h)+0.58(4P=0.008)。结论老年糖尿病患者具有明显空腹及餐后高胰岛素血症及明显的胰岛素抵抗;老年糖尿病患者空腹及餐后6h的TG水平与IAI和IR显著相关,提示胰岛素抵抗是老年糖尿病患者餐后血脂异常的发病机制之一。[Objective] Discuss relation of aged diabetic fat supersession disorder after meal with insulin sensitiveness. [Method] Test aged diabetic insulin acuity index （IAI） and insulin resistance index （IR） to assess insulin acuity, and research level of total cholesterol （TC）, triglycende （TG）, high density lipoprotein cholesterol （HDL-C）, low density lipoprotein cholesterol （LDL-C）, apolipoprotein A1 （APOA1） and apolipoprotein B （APOB） on an empty stomach and 2 h, 4 h, 6 h, 8 h after meal, discuss the relation between them. [Results] 1. Except insulin level of 2 h after meal, level of aged diabetic insulin on an empty stomach and 4 h, 6 h, 8 h is obviously higher than compared group （P 〈0.05 or P 〈0.01）; IR of aged diabetes group is notably higher than compared group （P =0.016）, 2. IAI and IR of aged diabetes group and compared group are notably inversely related （r =-0.812, -0.985）; and in aged diabetes group IAI and TG on an empty stomach, 4 h, 6 h and 8 h after meal are notably inversely related （r =-0.433, -0.429, -0.518, -0.451）; IR and BMI, waist hip ratio （WHR）, TG of 4 h, 6 h after meal are notably direefly related （r = 0.659, 0.554, 0.455, 0.498）. Multiple stepwise regression analyze： in aged diabetes group, except factors of age,BMI and WHR, with IAI and IR being dependent variable, each fat indexes on an empty stomach and 2 h, 4 h, 6 h,8 h after meal being independent variable, the regression equation is： IAI = -0.609 TC （6 h） - 0.385（ P = 0.031）, IR = 0.807 TG （6 h） ＋ 0.584 （P =0.008）. [Conclusions] Aged diabetic has obvious insulin resistance and high blood insulin on an empty stomach and after meal; aged diabetic TG level on an empty stomach and 6 h after meal is notably related with IAI and IR, referring insulin resistance is one of morbigenous mechanism of aged diabetic abnormal blood fat after meal.

关 键 词：老年糖尿病 脂代谢 口服脂肪餐负荷试验 胰岛素敏感性 

分 类 号：R587.1[医药卫生—内分泌]