新诊断型糖尿病患者血脂比值特点及短期胰岛素强化治疗对其影响  

Features of lipid ratios in patients with newly diagnosed T2DM and effects of intensive insulin treatment on them

作　　者：林秀红[1] 熊稀霖[2] 徐明彤[3] 唐菊英[3] 麦梨芳[3] 严励[3] 

机构地区：[1]中山大学孙逸仙纪念医院临床营养科,广州市510120 [2]中山大学孙逸仙纪念医院儿科,广州市510120 [3]中山大学孙逸仙纪念医院内分泌科,广州市510120

出　　处：《实用医学杂志》2017年第11期1781-1785,共5页The Journal of Practical Medicine

基　　金：国家自然科学基金(编号:81270915);广东省自然科学基金(编号:2015A030313042)

摘　　要：目的:观察新诊断2型糖尿病(T2DM)患者血脂比值的特点,并探讨短期胰岛素强化治疗对其影响。方法:入组90例新诊断T2DM患者及58例血糖正常对照者,测定两组的身高、体质量、血糖及血脂谱,计算BMI、TC/HDL-C、TG/HDL-C、log(TG/HDL-C)、LDL-C/HDL-C以及HOMA-B和HOMA-IR。T2DM组予胰岛素泵持续皮下输注胰岛素,血糖达标后维持10~14 d,复查上述指标。结果:与对照组相比,新诊断T2DM组血脂异常主要表现为高TG血症及低HDL-C血症比例较高(P<0.05),与HDL-C相关的各血脂比值明显升高(P<0.01)。短期胰岛素强化治疗后患者的各项血脂比值均较治疗前显著下降,且变化值均与HOMA-IR的变化值呈显著正相关(P<0.05)。结论:短期胰岛素强化治疗可显著降低新诊断T2DM患者中升高的HDL-C相关血脂比值,并与改善胰岛素抵抗密切相关。Objective To investigate the features of lipid ratios in patients with newly diagnosed T2DM, and the effects of intensive insulin treatment on them. Methods 90 patients with newly diagnosed T2DM and 58 matched people with normal glucose were enrolled to assess height, weight, waist circumference, blood glucose and lipid profiles. BMI, TC/HDL-C, TG/HDL-C, log （TG/HDL-C） , LDL-C/HDL-C, HOMA-B and HOMA-IR were calculated respectively. All the patients received the continuous subcutaneous insulin infusion with insulin pump. The treatment continued for more 10 - 14 days after blood glucose reached the standard. All the above indi- cators were reexamined after treatment. Results Dyslipidemia in patients with newly diagnosed T2DM mainly showed as hypertriglyceridemia and decreased HDL-C compared to the control group （P 〈 0.05）. TC/HDL-C, TG/ HDL-C, log （TG/HDL-C） and LDL-C/HDL-C significantly increased in these patients （P 〈 0.01 ）. After short-term intensive insulin therapy, all lipid ratios were significantly decreased and the changes of lipid ratios were positively correlated with the change of HOMA-IR （P 〈 0.05）. Conclusion Short-term intensive insulin therapy for patients with newly diagnosed type 2 diabetes can significantly lower the lipid ratios related to HDL-C. The effects may be closely related to improvement of insulin resistance.

关 键 词：2型糖尿病 新诊断 胰岛素强化治疗 血脂比值 

分 类 号：R587.1[医药卫生—内分泌]