2型糖尿病合并脂肪肝老年患者胰岛素抵抗及脂代谢状况分析  

Insulin Resistance and Fat Metabolism in Senile Patients with Type 2 Diabetes Combined with Fatty Liver

作　　者：王诗钰 史琴瑶 陈柳 谭惠文 WANG Shiyu;SHI Qinyao;CHEN Liu;TAN Huiwen(Department of Endocrine Nephropathy,Ganzi People＇s Hospital,Ganzi,Sichuan,62600)

机构地区：[1]甘孜州人民医院内分泌肾病科,四川甘孜626000

出　　处：《解放军预防医学杂志》2018年第8期993-995,999,共4页Journal of Preventive Medicine of Chinese People's Liberation Army

基　　金：2017年四川省卫生和计划生育委员会科研课题(No.17PJ115)

摘　　要：目的分析2型糖尿病合并脂肪肝患者胰岛素抵抗及脂代谢状况。方法回顾性分析我院2015年3月-2017年3月收治的90例2型糖尿病合并脂肪肝患者的诊疗情况。按照是否合并脂肪肝,将患者分为观察组(45例)和对照组(45例)。对照组为2型糖尿病患者;观察组为2型糖尿病合并脂肪肝患者。观察两组患者的胰岛素抵抗指标、血糖控制水平、脂代谢指标及炎性因子的差异。结果观察组的空腹胰岛素(FINS)、2 h胰岛素(2hINS)明显高于对照组,而胰岛素抵抗指数(HOMA-IR)、胰岛素敏感指数(ISI)则显著低于对照组,两组比较差异有统计学意义(P<0.05)。观察组的空腹血糖(FPG)、餐后2 h血糖(2h PG)和糖化血红蛋白(HbA1c)明显高于对照组,两组比较差异具有统计学意义(P<0.05)。观察组的甘油三酯(TG)、总胆固醇(TC)明显高于对照组,而高密度脂蛋白(HDL)、低密度脂蛋白(LDL)则显著低于对照组,两组比较差异有统计学意义(P<0.05)。观察组的IL-6、hs-CRP及NF-κB血清炎性指标显著高于对照组,差异具有统计学意义(P<0.05)。结论 2型糖尿病合并脂肪肝患者存在明显的脂代谢紊乱、血糖控制水平指标升高及高胰岛素血症等。预防2型糖尿病合并脂肪肝主要从减轻IR、防止高胰岛素血症和维持正常脂代谢等方面展开研究。Objective To study insulin resistance and fat metabolism in elder patients with type 2 diabetes combined with fatty liver. Methods Ninety cases of patients with type 2 diabetes combined with fatty liver were divided into the observation group（ 45 cases） and the control group（ 45 cases）. The control group was composed of patients with type 2 diabetes while the observation group consisted of patients with type 2 diabetes combined with fatty liver. The insulin resistance index,blood glucose control level and fat metabolism index of the two groups were compared. Results Levels of FINS and 2 h INS of the observation group were significantly higher than those of the control group while levels of HOMA-IR and ISI of the observation group were significantly lower. The difference was statistically significant（ P〈0.05）. FPG,2 h PG and HbA1c of the observation group were significantly higher than those of the control group（ P〈0.05）. TG and TC of the observation group were significantly higher than those of the control group while HDL and LDL of the observation group were significantly lower. The difference was statistically significant（ P〈0.05）. IL-6,hs-CRP and NF-k B of the observation group were much higher than those of the control group. The difference was statistically significant（ P〈0.05）. Conclusion Patients with type 2 diabetes mellitus and fatty liver have obvious disorder of lipid metabolism,higher indicators of blood glucose control and hyperinsulinemia. Prevention of type 2 diabetes with fatty liver,to some extent,depends on the study of how to reduce IR,prevent hyperinsulinemia and maintain normal lipid metabolism.

关 键 词：2型糖尿病 脂肪肝 胰岛素抵抗 脂代谢 

分 类 号：R587.1[医药卫生—内分泌]