初诊2型糖尿病患者胰岛素抵抗与肾素血管紧张素醛固酮系统的关系  

Correlation between insulin resistance and renin-angiotensin-aldosterone system in newly diagnosed type 2 diabetes mellitus

作　　者：黄祺[1] 朱圣炜[1] 浦丹凤[1] 程海燕[1] 卜瑞芳[1] 

机构地区：[1]南京医科大学附属无锡人民医院内分泌科,214023

出　　处：《实用医学杂志》2016年第20期3299-3302,共4页The Journal of Practical Medicine

摘　　要：目的:探讨初诊的2型糖尿病患者胰岛素抵抗与肾素血管紧张素醛固酮系统(RASS)的关系,为糖尿病合并有高血压病的患者提供最佳的治疗方案。方法:初诊的90例2型糖尿病患者根据性别分层后以有无高血压病史分成合并组和非合并组,前者再根据服降压药的情况分成未服药组、服钙通道阻滞剂(CCB)组、服血管紧张素受体拮抗剂(ARB)组。结果:女性合并有高血压病组IAI、肾素及血管紧张素Ⅱ水平高于非合并组。服降压药者血压明显较未用药者低,女性组中服用ARB的收缩压较服用CCB者更低。Pearson相关分析显示女性组中HOMA-IR与血管紧张素Ⅱ及醛固酮的水平呈正相关,IAI与血管紧张素Ⅱ及醛固酮的水平呈负相关。结论:在初诊的2型糖尿病女性患者中RASS参与胰岛素抵抗的发生发展,因此首选RASS拮抗剂有助于更好地控制血糖。Objective To study the relationship between insulin resistance and renin-angiotensinaldosterone system（RASS） in newly diagnosed type 2 diabetes mellitus, and to provide the best treatment for type 2 diabetes mellitus with hypertension. Methods Ninety cases of newly diagnosed type 2 diabetes mellitus were included. After stratified by gender, all the patients were divided into hypertension group and nonhypertension group. According to whether taking hypotensor, the patients with hypertension were further divided into non-medication group, calcium channel blockers（CCB） group, and angiotensin receptor blockers（ARB）group respectively. Results In female patients with hypertension, the IAI, levels of rennin and angiotensin II were higher than those in non-hypertension group and the systolic pressure of female patients taking ARB was lower than those taking CCB. Pearson′ s correlation analysis showed that angiotensin II and aldosterone was positively correlated with HOMA-IR but negatively correlated with IAI in females. Conclusions In female newly diagnosed type 2 diabetes mellitus, RASS is related to the development of insulin resistance, so RASS antagonists are the first choice to achieve better blood glucose control in female patients.

关 键 词：糖尿病 2型 胰岛素抵抗 肾素血管紧张素醛固酮系统 

分 类 号：R587.1[医药卫生—内分泌]