胰岛素抵抗与非糖尿病维持性血液透析患者颈动脉粥样硬化相关性分析  

Relationship of insulin resistance and carotid artery atherosclerosis in maintenance hemodialysis patients without diabetes

作　　者：池向耿[1] 禤杏华[1] 胡绮雯[1] 丁德良[1] 

机构地区：[1]广东中山市小榄人民医院肾内科,528415

出　　处：《临床肾脏病杂志》2013年第5期225-227,共3页Journal Of Clinical Nephrology

摘　　要：目的探讨维持性血液透析患者胰岛素抵抗与颈动脉粥样硬化的相关性。方法将78例非糖尿病肾脏疾病的维持性血液透析患者，根据胰岛素敏感度分为胰岛素抵抗组（A组）和胰岛素敏感组（B组），比较2组颈动脉粥样硬化发生率和各相关因素指标；同时，对颈动脉粥样硬化影响因素进行Logistics回归分析，胰岛素抵抗与颈动脉粥样硬化相关因素进行单因素回归分析。结果A组血脂、血磷、同型半胱氨酸、超敏c反应蛋白（hs—CRP）、白细胞介素6（IL-6）、甲状旁腺素（iPTH）、颈动脉粥样硬化发生率与B组存在明显差异（P〈0．05），对胰岛素敏感性与各危险因素进行Logistic回归分析，发现胰岛素抵抗与高血脂、微炎症相关（P〈0．05）。结论胰岛素抵抗是颈动脉粥样硬化的危险因素，其机制可能与微炎症、脂代谢异常有关。Objective To explore the relationship between insulin resistance （IR） and carotid artery atherosclerosis （CA） or greater carotid artery intima-media thickness （CIMT） in maintenance hemodialysis patients without diabetes. Methods Seventy-eight maintenance hemodialysis patients were divided into two groups by sensitivity of insulin. Risk factors of CA were compared in the two groups and the relationship between IR and every CA risk factor was analyzed by Logistic regression. Results There was statistically significant difference between the two groups in LDL, TG, total ho- mocysteine, hsCRP, serum phosphorus, IL-6, and CA rate （P^0. 05）. Logistic regression revealed hyperlipemia （LDL and TG） and microinflammtion （hsCRP and IL-6） were related with insulin resist- ance in maintenance hemodialysis patients. Conclusions Insulin resistance was an independent risk fac- tor of greater CIMT or CA.

关 键 词：血液透析 胰岛素抵抗 颈动脉粥样硬化 颈动脉中膜 微炎症 

分 类 号：R459.5[医药卫生—治疗学]