超重及肥胖对2型糖尿病患者凝血功能及代谢指标的影响研究  

Impact on Coagulation and Metabolic Indicators by Overweight and Obesity in Pateints with Type 2 Diabetes Mellitus

作　　者：胡怡[1,2] 陈思娇[1] 李红燕[1] 杨红艳[1] 朱贺[1] 郭英华[1] 宋今丹[3] 

机构地区：[1]中国医科大学附属第一医院干部医疗工作部老年医学研究室,辽宁省沈阳市110001 [2]青岛大学医学院附属医院特需保健科 [3]中国医科大学医学分子生物学研究所卫生部教育部医学细胞生物学重点实验室

出　　处：《中国全科医学》2011年第5期478-481,共4页Chinese General Practice

基　　金：辽宁省科技攻关项目(2007225004-3);沈阳市科学技术计划项目(1071162-9-00);辽宁省教育厅科技攻关项目(2008818)

摘　　要：目的探讨超重、肥胖对2型糖尿病凝血功能及代谢指标的影响。方法选取2008年本院干部病房和体检中心收治的初诊2型糖尿病患者,测量身高、体质量,计算体质指数（BM I）。根据BM I将患者分为对照组（BM I在18.5~23.9 kg/m2）、超重组（BM I在24.0~27.9 kg/m2）、肥胖组（BM I≥28.0 kg/m2）,均测定血浆纤维蛋白原（FIB）、血浆凝血酶原时间（PT）、血浆活化部分凝血酶原时间（APTT）、尿微量清蛋白（MAU）、尿肌酐（Ucr）、血脂〔包括三酰甘油（TG）、总胆固醇（TC）、低密度脂蛋白胆固醇（LDL-C）、高密度脂蛋白胆固醇（HDL-C）〕、空腹血糖（FBG）及空腹胰岛素（FINS）,计算胰岛素抵抗指数（HOMA-IR）及微量清蛋白与肌酐的比较（UACR）,比较3组患者上述指标的差异。结果与对照组比较,超重组、肥胖组患者的FIB、UACR、TG、TC、LDL-C、FBG、FINS水平及HOMA-IR显著升高,且随肥胖程度的增加而呈上升趋势（P〈0.05）;而PT、APTT、HDL-C水平则显著降低,且随肥胖程度的增加而呈下降趋势（P〈0.05）。结论超重及肥胖会加重2型糖尿病的凝血功能障碍及代谢紊乱,并加重了胰岛素抵抗的程度,且此异常随肥胖程度的加深而更加严重。Objective To learn the impact on coagulation and metabolic disorders by overweight and obesity in patients with type 2 diabetes mellitus by measuring blood clotting and metabolism-related indicators.Methods The newly diagnosed type 2 diabetes patients in 2008 were involved into the study.Their height and weight were measured and body mass index（BMI） calculated.They were divided into control group,overweight group and obesity group according to their BMI.Statistical processing and analysis were made after measuring FIB,PT,APTT,MAU,Ucr,TG,TC,LDL-C,HDL-C,FBG,FINS and calculating HOMA-IR,UACR.Results Compared with the control group,the level of FIB,UACR,TG,TC,LDL-C,FBG,FINS,HOMA-IR in overweight group and obesity group were significantly higher,and the more the obesity was,the higher it would be（P0.05）.But the level of PT,APTT,HDL-C in overweight group and obesity group was significantly lower,and the more the obesity was,the lower it would be（P0.05）.Conclusion Overweight and obesity can aggravate the coagulation and metabolic disorders of type 2 diabetes mellitus.It also increases the degree of Insulin Resistance,which will be aggravated with the increasing seriousness of obesity.

关 键 词：超重 肥胖症 凝血功能 胰岛素抵抗 尿微量清蛋白与肌酐的比值 

分 类 号：R587.1[医药卫生—内分泌]