胰岛素抵抗与Ⅱ型糖尿病患者左心室质量指数、心功能的相关性分析  

Correlation between insulin resistance and cardiac hypertrophy and function in typeⅡdiabetic patients

作　　者：周丽诺[1] 沈稚舟[1] 李红[2] 钟怀琴 范维琥[1] 朱禧星[1] 

机构地区：[1]上海复旦大学附属华山医院,上海200040 [2]江苏淮安市第二人民医院 [3]华东疗养院

出　　处：《中国心血管杂志》2002年第4期242-244,共3页Chinese Journal of Cardiovascular Medicine

摘　　要：目的　了解 型糖尿病患者胰岛素抵抗与左心室肥大、心功能减退的关系。方法　用 HOMA— IR公式计算胰岛素抵抗指数 (IR) ,二维和超声多普勒心动图测定糖尿病患者的心脏结构和心脏收缩舒张功能 ,并计算左心室质量指数 (L VMl)。结果　在口服磺脲类和同时注射胰岛素组 (S+I组 ) ,IR和 L VMI较高 ,E/ A>I的比例较少 :多元逐步回归显示 L VMI与年龄、IR、Hb Al C呈正相关 ,与射血分数 (EF)负相关 ;直线相关分析提示 :在口服磺脲类组 (S)和 (S+I)组 ,L VMI与 IR呈正相关、与 EF负相关 ;在 S组 ,L VMI还与 Hb Al C正相关 ,而口服磺脲类加二甲双胍 (S+M)组这样的关系未见。结论　在 型糖尿病中 ,胰岛素抵抗是左心室肥厚的重要危险因素 ,这种关系在使用胰岛素和 /或磺脲类的患者中比较明显。而双胍类药物对糖尿病心脏可能具有保护作用。Objectives To survey the relationship of insulin resistance with left ventricular mass index(LVMI) in type 2 diabetic patients.Methods 101 type Ⅱ diabetic patients were divided into three groups according the drug used.Homa IR formula was used for the calculation of insulin resistance.Two dimension and Doppler echocardiography were performed.The LVMI was calculated by the equation of Devereux.Results In the group S+I and S, IR and LVMI were increased and the proporfion of E/A>1 was lower; Multiple regression showed: the LVMI were positively correlated to IR, HbA1C and age and negatively correlated to EF. (p value was 0.002, 0.001, 0.024, 0.006 and 0.000, respectively). Liner regression suggested, LVMI was correlated to IR and EF in S and S+I group. LVMI also correlated to HbAIC in S group. It did not show any significant correlationship between LVMI with IR, EF in S+M group. Conclusions In type II diabetic patients, insulin resistance is the major risk factor on cardiac hypertrophy. It manifested clearly in the diabetics who take sulfonylureas only or and insulin injection. Metafomin might provide some benefit effects on diabetic heart.

关 键 词：胰岛素抵抗 糖尿病 左心室质量指数 超声心动图 

分 类 号：R587.1[医药卫生—内分泌]