老年2型糖尿病患者血脂与胰岛素抵抗及胰岛β细胞功能的关系  

Relationship between Lipid and Insulin Resistance and Islet β Cell Function in Elderly Patients with Type 2 Diabetes

作　　者：薛嫱[1] 邓晓慧[1] 宋丽清[1] 田巍[1] Xue Qiang;Deng Xiaohui;Song Liqing(Department of Cadres' Healthcare,Beijing Jishuitan Hospital,Beijing 100035,China)

机构地区：[1]北京积水潭医院干部保健科

出　　处：《医学研究杂志》2019年第5期94-97,133,共5页Journal of Medical Research

基　　金：北京市保健科研基金资助项目(京11-06)

摘　　要：目的探讨老年2型糖尿病患者血脂与胰岛素抵抗及胰岛β细胞功能的关系。方法选择2016年4月~2018年3月期间在北京积水潭医院住院的老年糖尿病患者(年龄≥65岁)120例,测定空腹血糖(fasting plasma glucose,FBG)、空腹胰岛素(fasting insulin,FINS)及总胆固醇(total cholesterol,TC)、甘油三酯(triglyceride,TG)、高密度脂蛋白胆固醇(high-density lipoprotein cholesterol,HDL-C)、低密度脂蛋白胆固醇(low-density lipoprotein cholesterol,LDL-C)水平。用稳态模型评估法(homeostasis model aseessment,HOMA)计算胰岛β细胞功能(homa islet beta cell function index,HOMA-β)及胰岛素抵抗(homa insulin- resistance,HOMA-IR)相关指数,评估血脂与HOMA-β及HOMA-IR指数的关系。结果 TC与体重指数(body mass index,BMI)及FBG相关;LDL-C与BMI、FBG及HOMA-IR相关;LDL-C≥2.6mmol/L的患者BMI、FBG及HOMA-IR明显高于 LDL- C<2.6mmol/L 组。校正性别、年龄、糖尿病病程、BMI的影响后,LDL-C与HOMA-IR的相关性差异有统计学意义。结论在非胰岛素治疗的老年2型糖尿病患者中,LDL-C与肥胖及胰岛素抵抗相关,但未发现血脂成分与胰岛β细胞功能相关。Objective To explore the relationship between lipid and insulin resistance and islet β cell function in advanced age patients with type 2 diabetes.Methods A total of 120 patients with type 2 diabetes (older than 65 years old) admitted in our hospital from April 2016 to March 2018 were recruited in this study.Selected objects are measured fasting plasma glucose,fasting insulin,total cholesterol,triglyceride,high-density lipoprotein cholesterol and low-density lipoprotein cholesterol.Homeostasis model assessment of secretory function of islet β cell and insulin resistance were evaluated.The relationship between lipid and insulin resistance and islet β cell function were evaluated.Results Triglyceride was related to body mass index and fasting plasma glucose.Low-density lipoprotein cholesterol was related to body mass index,fasting plasma glucose and HOMA-IR.Body mass index,fasting plasma glucose and HOMA-IR in patients with LDL-C≥2.6mmol/L were significantly higher than patients with LDL-C<2.6mmol/L.There was significant relationship between LDL-C and HOMA-IR after adjusting sex,age,course of diabetes and body mass index.Conclusion LDL-C is related to obesity and HOMA-IR in non-insulin treatment of diabetic elderly patients.However,no relationship was found between blood lipids and islet beta cell function.

关 键 词：糖尿病 血脂 胰岛素抵抗 胰岛Β细胞功能 

分 类 号：R587.1[医药卫生—内分泌] R589.2[医药卫生—内科学]