新疆哈萨克族肥胖、胰岛素抵抗与心血管危险因素的关系  

Correlations of Xinjiang Kazak obesity and insulin resistance to cardiovascular risk factors

作　　者：鲜木斯娅.肉孜 刘庆军[1] 王建疆 陈福和 许君 谢自敬[1] 毛新民[3] 李琳琳[3] 

机构地区：[1]新疆医科大学第一附属医院内分泌科,新疆维吾尔自治区乌鲁木齐市830011 [2]新疆阿勒泰布尔津县人民医院内分泌科 [3]新疆医科大学药学院,新疆维吾尔自治区乌鲁木齐市833000

出　　处：《中国组织工程研究与临床康复》2009年第41期8166-8169,共4页Journal of Clinical Rehabilitative Tissue Engineering Research

基　　金：新疆维吾尔自治区重点科技攻关项目(200633129)~~

摘　　要：目的:探索哈萨克族人群肥胖、胰岛素抵抗与心血管危险因素的关系。方法:于2007年在新疆阿勒泰地区布尔津县5个乡按自然村进行随机抽样,按以往调查结果计算样本含量,对人口统计学资料由培训过的调查员进行问卷调查,并进行人体测量指标测量,血糖采用葡萄糖氧化酶法﹑血脂采用酶法测定。实验室指标由国家质控达标实验室进行测定,所有实验室结果均精确到小数点后2位。结果:①哈萨克族胰岛素抵抗与周围型肥胖有特殊关系,超重与轻度肥胖者没有胰岛素抵抗,重度周围型肥胖者(Ⅱ度肥胖)才发生胰岛素抵抗。②哈萨克族男女两性的内脏型肥胖与胰岛素抵抗没有线性关系。只有中等程度的胰岛素抵抗(HOMA-IR2,HOMA-IR3)与内脏型肥胖相关,而重度胰岛素抵抗(HOMA-IR4)男女两性均与内脏型肥胖无关。③周围型肥胖对胰岛素抵抗的作用大于内脏型肥胖,是内脏型肥胖的1倍以上。④哈萨克族的血压升高、血脂紊乱及高血糖等心血管危险因素主要分布在严重胰岛素抵抗患者中,尤其高血糖96.5%发生在重度胰岛素抵抗者,只有5%为Ⅲ度胰岛素抵抗,Ⅰ及Ⅱ度胰岛素抵抗者不出现血糖升高。结论:哈萨克族高血压、血脂紊乱及糖调节异常主要发生在重度肥胖患者,影响这些心血管危险因素主要是严重胰岛素抵抗患者,影响胰岛素抵抗既有周围性肥胖,也有中心性肥胖,但主要是周围性肥胖,这一结果与国内外其他民族不同。OBJECTIVE： To explore the correlations of the Kazak obesity and insulin resistance to cardiovascular risk factors. METHODS： Random sampling was carried out in five rural villages of Burjin county of Xinjiang Altay city in 2007. Samples were calculated in accordance with the previous findings of the same research. A questionnaire survey of demographic information was conducted by trained investigators. Blood glucose was tested by using glucose oxidase method, and blood lipid was tested by using enzymatic method. Laboratory indicators were tested in accordance with the quality control standards of the National Measurement Laboratory. All the laboratory results were rounded to two decimal places. RESULTS：① There is a special relationship between Kazak insulin resistance and the peripheral obesity, overweight and mild obesity people do not have insulin resistance. However, severe peripheral obesity people have insulin resistance.② There is no linear relationship between visceral obesity and insulin resistance of Kazak men and women. Only moderate insulin resistance（HOMA-IR2, HOMA-IR3） is related to visceral obesity. However severe insulin resistance （HOMA-IR4） of both sexes is not related to visceral obesity. ③ Peripheral obesity has a greater effect than visceral obesity on insulin resistance. ④ The hypertension, dyslipidemia, high blood sugar, and other cardiovascular risk factors in Kazaks are mainly distributed in patients with severe insulin resistance. Especially, 96.5% of hyperglycemia occurs in severe insulin resistance, only 5% occurs in the third degree insulin resistance. The first and second degree insulin resistance usually does not lead to high blood sugar. CONCLUSION： The hypertension, dyslipidemia and abnormal glucose regulation in Kazaks mainly occur in patients with severe obesity. These cardiovascular risk factors are often seen in severe insulin resistance patients. Peripheral obesity and central obesity, especially the former one, easily lead to insulin resistance. W

关 键 词：哈萨克族 肥胖 胰岛素抵抗 高血糖 

分 类 号：R587.1[医药卫生—内分泌]