脂肪组织胰岛素抵抗与新诊断2型糖尿病患者亚临床动脉粥样硬化的相关性研究  

Relationship between adipose tissue insulin resistance and subclinical atherosclerosis in patients with newly diagnosed type 2 diabetes mellitus

作　　者：于恒池[1] 尹洁[1] 洪旭[1] 靳二虎[2] Yu Hengchi;Yin Jie;Hong Xu;Jin Erhu(Department of Endocrinology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China;Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China)

机构地区：[1]首都医科大学附属北京友谊医院内分泌科,100050 [2]首都医科大学附属北京友谊医院放射科,100050

出　　处：《中国医师进修杂志》2019年第5期410-413,共4页Chinese Journal of Postgraduates of Medicine

基　　金：北京市自然科学基金(7122048)。

摘　　要：目的探讨脂肪组织胰岛素抵抗与新诊断2型糖尿病患者亚临床动脉粥样硬化的相关性。方法回顾性分析首都医科大学附属北京友谊医院2012年3月至2013年3月102例新诊断2型糖尿病患者的临床资料,将患者按颈动脉内膜中层厚度(cIMT)分为cIMT增厚组(cIMT ≥ 0.9 mm,44例)和cIMT正常组(cIMT<0.9 mm,58例),记录空腹胰岛素(FINS)、游离脂肪酸(FFA)、空腹血糖(FBG)及血脂等,计算脂肪组织胰岛素抵抗指数(Adipo-IR)和稳态模型评估法胰岛素抵抗指数(HOMA-IR)。结果102例新诊断2型糖尿病患者cIMT(0.85 ± 0.15)mm。cIMT增厚组年龄、三酰甘油、FFA、HOMA-IR和Adipo-IR明显高于cIMT正常组[(50.82 ± 12.45)岁比(41.41 ± 10.61)岁、(2.43 ± 0.78)mmol/L比(2.14 ± 0.70)mmol/L、(0.58 ± 0.09)mmol/L比(0.48 ± 0.10)mmol/L、5.57 ± 2.88比4.11 ± 1.93和8.39 ± 3.72比5.69 ± 3.05],差异有统计学意义(P<0.01或<0.05)。Logistic回归分析结果显示,新诊断2型糖尿病患者cIMT增厚与年龄、Adipo-IR独立相关(OR= 1.119和1.473,P= 0.002和0.003,95% CI 1.041~1.201和1.144~1.895)。结论脂肪组织胰岛素抵抗是新诊断2型糖尿病患者亚临床动脉粥样硬化的独立危险因素。Objective To investigate the relationship between adipose tissue insulin resistance and subclinical atherosclerosis in patients with newly diagnosed type 2 diabetes mellitus. Methods The clinical data of 102 patients with newly diagnosed type 2 diabetes mellitus from March 2012 to March 2013 in Beijing Friendship Hospital, Capital Medical University were retrospectively analyzed. According to the carotid artery intima media thickness (cIMT) by ultrasonography, the patients were divided into cIMT thickening group (cIMT ≥ 0.9 mm, 44 cases) and cIMT normal group (cIMT<0.9 mm, 58 cases). The fasting insulin (FINS), free fatty acids (FFA), fasting blood glucose (FBG) and blood lipids were measured, and the adipose tissue insulin resistance index (Adipo-IR) and homeostatic model assessment insulin resistance index (HOMA-IR) were calculated. Results The cIMT of 102 patients with newly diagnosed type 2 diabetic mellitus was (0.85 ± 0.15) mm. The age, triglyceride, FFA, HOMA-IR and Adipo-IR in cIMT thickening group were significantly higher than those in cIMT normal group:(50.82 ± 12.45) years vs.(41.41 ± 10.61) years,(2.43 ± 0.78) mmol/L vs.(2.14 ± 0.70) mmol/L,(0.58 ± 0.09) mmol/L vs.(0.48 ± 0.10) mmol/L, 5.57 ± 2.88 vs. 4.11 ± 1.93 and 8.39 ± 3.72 vs. 5.69 ± 3.05, and there were statistical differences (P<0.01 or <0.05). Logistic regression analysis result showed that cIMT thickening was independently associated with age and Adipo-IR in patients with newly diagnosed type 2 diabetes mellitus (OR= 1.119 and 1.473, P= 0.002 and 0.003, 95% CI 1.041 to 1.201 and 1.144 to 1.895). Conclusions Adipose tissue insulin resistance is an independent risk factor for subclinical atherosclerosis in patients with newly diagnosed type 2 diabetic mellitus.

关 键 词：糖尿病 2型 脂肪组织 动脉粥样硬化 胰岛素抗药性 回顾性研究 

分 类 号：R587.2[医药卫生—内分泌]