吸烟与慢性阻塞性肺疾病患者胰岛素抵抗的相关性研究  

Smoking and Insulin Resistance: A Correlation Study in COPD Patients

作　　者：薛旗山[1] 闫春良[1] 雷芸[1] 聂晓莉[1] 张慧娟[1] 任冠军[1] 

机构地区：[1]北京航天总医院呼吸内科,北京市100076

出　　处：《中国全科医学》2014年第29期3439-3441,共3页Chinese General Practice

摘　　要：目的探讨吸烟与慢性阻塞性肺疾病(COPD)患者胰岛素抵抗的关系。方法选取2012年1月—2013年5月在北京航天总医院就诊的COPD患者114例,根据吸烟史分为吸烟组(75例)与非吸烟组(39例);将吸烟组患者再根据吸烟指数分为吸烟指数≥600支/年亚组和吸烟指数<600支/年亚组。另选择同期本院不吸烟的体检健康者26例为对照组。检测所有受试者的肺功能及空腹血糖(FBG)、C反应蛋白(CRP)、空腹胰岛素(FINS)、三酰甘油(TG)、总胆固醇(TC)、尿微量清蛋白(MALB)水平,并计算胰岛素抵抗指数(HOMA-IR)。结果吸烟组较非吸烟组第1秒用力呼气容积占预计值百分比(FEV1%)、FEV1/用力肺活量(FVC)下降,两组均较对照组下降,差异有统计学意义(P<0.05)。吸烟组较非吸烟组CRP、TG、MALB升高,两组均较对照组升高,差异有统计学意义(P<0.05)。吸烟指数≥600支/年亚组和吸烟指数<600支/年亚组FBG、FINS、HOMA-IR及胰岛素抵抗发生率间差异均有统计学意义(P<0.05),且均高于对照组和非吸烟组,差异有统计学意义(P<0.05)。结论吸烟与COPD患者胰岛素抵抗存在相关性,吸烟是COPD发生胰岛素抵抗的潜在危险因素。Objective To investigate the relationship between smoking and insulin resistance（ IR） in patients with chronic obstructive pulmonary disease（ COPD）. Methods A total of 114 COPD patients who visited Beijing Aerospace General Hospital from Januray 2012 to May 2013 were divided,according to smoking history,into groups smoking（ n = 75） and non-smoking（ n = 39）. The smoking group were subdivided,according to smoking index,into subgroups ≥600 cigarettes /year and 600 cigarettes /year. Twenty- six healthy subjects who did not smoke were enrolled as control group. We determined lung function and fasting blood glucose（ FBG）,C- reactive protein（ CRP）,fasting insulin（ FINS）,triglyceride（ TG）,total cholesterol（ TC）,urinary microalbumin（ MALB） and calculated insulin resistance index（ HOMA- IR）. Results The FEV1%,FEV1/FVC were lower in smoking group than in non- smoking group,lower in groups smoking,non- smoking than in control group,the difference was significant（ P 0. 05）. CRP,TG,MALB were higher in smoking group than in non-smoking group,higher in groups smoking,non- smoking than in control group（ P 0. 05）. There was difference in FBG,FINS,HOMA- IR and IR incidence between 2 subgroups（ P 0. 05）,and higher in two subgroups than in groups control and non- smoking（ P 0. 05）. Conclusion Smoking,associated with IR,is a potential risk factor for COPD IR.

关 键 词：肺疾病 慢性阻塞性 吸烟 胰岛素抵抗 

分 类 号：R563[医药卫生—呼吸系统]