2型糖尿病合并胆结石、胆囊炎患者胰岛素抵抗的研究  

The study of insulin resistance in type 2 diabetes patients with cholelithiasis and cholecystitis

作　　者：石昌红[1] 邓仰欣[1] 牛铭芸[1] 宋晓[1] 黄东辉[1] 郭征东[1] 

机构地区：[1]山东省泰山医学院附属医院,271000

出　　处：《中国实用医药》2008年第24期33-34,共2页China Practical Medicine

摘　　要：目的探讨2型糖尿病合并胆结石、胆囊炎患者与血脂、胰岛素抵抗(IR)的关系。方法160例2型糖尿病(T2DM)患者根据胆囊B超显示的结石和胆囊炎有无分成2组:糖尿病伴结石、胆囊炎组和糖尿病不伴组,选择同期非糖尿病无胆结石、胆囊炎住院患者40例作为对照组。所有对象均做空腹B超,测量身高、体质量、腰围、臀围,抽取静脉血测血糖、空腹胰岛素、空腹和餐后2 h C肽、血脂,计算体重指数(BMI)、腰臀围比(WHR)、胰岛素抵抗指数(HOMA-IR)。结果2型糖尿病患者血胆固醇(TC)、甘油三酯(TG)、HOMA-IR、空腹和餐后2 h C肽均明显高于对照组(P<0.05)。糖尿病伴结石、胆囊炎组和糖尿病不伴结石、胆囊炎组比较,血胆固醇、HOMA-IR、空腹和餐后2 h C肽明显升高(P<0.05),HDL-C明显降低(P<0.01)。结论2型糖尿病患者易患胆结石、胆囊炎可能与血脂代谢紊乱、胰岛素抵抗有关,减轻胰岛素抵抗,调节血脂是降低2型糖尿病患者胆结石、胆囊炎发病率的关键。Objective To investigate the relationship of insulin sensitivity and the serum lipid level in type 2 diabets patient with cholelithiasis and cholecystitis. Methods 160 T2DM patients underwent gallbladder uhrasonograpfy firstly and thenwere divided into 2 groups according to the result of gallbladder uhrasonograpfy ： T2DM with cholelithiasis and cholecystitis and T2DM without cholelithiasis and Cholecystitis. Then contrast in parallel with 40 non-diabetic individuals in hospital at the same time. All subjects were measured blood glucose, lipid, fasting insulin, C-peptide, height, weight,, waist-to-hip ratio. The homeostasis model assessment insulin resistance（HOMA-IR） was caculated in three groups. Results The TC, TG and HOMA-IR in T2DM were higher than that in contrast groups（ P 〈 0.05 ）. The CH and HOMA-IR in T2DM with cholelithiasis and cholecystitis were higher than that in T2DM without cholelithiasis and Cholecystitis （ P 〈 0.05 ）. Then HDL in T2DM with cholelithiasis and cholecystitis was lower than that in T2DM without cholelithiasis and Cholecystitis（P 〈 0.05）. Conclusion T2DM appear more susceptible to cholelithiasis and Cholecystitis,which count much for insulin resistance and lipid decompensation.

关 键 词：2型糖尿病 胰岛素抵抗 胆囊炎 胆结石 

分 类 号：R587.1[医药卫生—内分泌] R657.42[医药卫生—内科学]