2型糖尿病合并代谢综合征患者胰岛素抵抗指数与慢性炎症指标相关性研究  

Correlation of insulin resistance index and chronic in?ammation index in type 2 diabetes mellitus patients with metabolic syndrome

作　　者：刘晓妮[1] 王颖[1] 李桃桃[1] 马小敏[1] 赵换牢 LIU Xiaoni;WANG Ying;LI Taotao;MA Xiaomin;ZHAO Huanlao(Department of Endocrinology,Yan'an People's Hospital,Yan'an 716000,Shaanxi,China;Department of Endocrinology and Metabolism,the Third Hospital of People's Liberation Army,Baoji 712000,Shaanxi,China)

机构地区：[1]延安市人民医院内分泌科,陕西延安716000 [2]解放军第三医院内分泌代谢科,陕西宝鸡712000

出　　处：《检验医学》2019年第9期826-830,共5页Laboratory Medicine

摘　　要：目的探讨2型糖尿病(T2DM)合并代谢综合征(MS)患者胰岛素抵抗指数(HOMA-IR)与慢性炎症之间的关系。方法选取T2DM患者90例,根据有无合并MS分为无MS的T2DM患者(单纯T2DM组,40例)和合并MS的T2DM患者(T2DM合并MS组,50例)。以体检健康且血糖正常者40名作为正常对照组。收集3个组的临床资料及生化指标检测结果并作比较。采用Pearson相关分析评估各项目之间的相关性。结果T2DM合并MS组腰围、臀围、腰臀比(WHR)、体质量指数(BMI)、收缩压、舒张压、三酰甘油(TG)、致动脉粥样硬化指数(AIP)、空腹血糖、高敏C反应蛋白(hs-CRP)、非高密度脂蛋白胆固醇(non-HDL-C)及空腹胰岛素均明显高于正常对照组和单纯T2DM组(P<0.05),单纯T2DM组与正常对照组之间差异均无统计学意义(P>0.05)。正常对照组、单纯T2DM组、T2DM合并MS组HOMA-IR和TG/高密度脂蛋白胆固醇(HDL-C)比值依次升高(P=0.000),HDL-C水平依次降低(P=0.000),年龄及总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)水平3组之间差异均无统计学意义(P>0.05)。T2DM合并MS患者HOMA-IR与空腹血糖、TG及腰围均呈正相关(r值分别为0.589、0.315、0.332,P=0.000),与HDL-C呈负相关(r=-0.188,P=0.000);hs-CRP与空腹血糖、TG及腰围均呈正相关(r值分别为0.168、0.172、0.338,P<0.05);HOMA-IR与hs-CRP呈正相关(r=0.353,P=0.019)。结论T2DM合并MS患者的HOMA-IR与致动脉粥样硬化、全身慢性炎症以及TG/HDL-C比值有关。Objective To investigate the correlation of homeostasis model assessment for insulin resistance(HOMA-IR)and chronic inflammation index in type 2 diabetes mellitus(T2DM)patients with metabolic syndrome(MS).Methods A total of 90 patients with T2DM were enrolled and classified into T2DM patients without MS(T2DM group,40 cases)and T2DM patients with MS(T2DM with MS group,50 cases).Totally,40 healthy subjects with normal blood glucose were enrolled as healthy control group.The clinical data of 3 groups and biochemical indexes were collected and compared.Pearson correlation analysis was used.Results In T2DM with MS group,waist to hip ratio(WHR),body mass index(BMI),waist circumference and hip circumference,systolic blood pressure,diastolic blood pressure,triglyceride(TG),atherogenic index of plasma(AIP),fasting blood glucose,fasting insulin,high-sensitivity C-reactive protein(hs-CRP)and non-high-density lipoprotein cholesterol(non-HDL-C)were higher than those in healthy control group and T2DM group(P<0.05),while there was no statistical significance between T2DM group and healthy control group(P>0.05).The ratios of HOMA-IR and TG/high-density lipoprotein cholesterol(HDL-C)increased in turn from healthy control group,T2DM group to T2DM with MS group(P=0.000),HDL-C levels decreased in turn(P=0.000),and there was no statistical significance in age,total cholesterol(TC)and low-density lipoprotein cholesterol(LDL-C)levels among the 3 groups(P>0.05).For T2DM with MS group,HOMA-IR,fasting blood glucose,TG and waist circumference were positively correlated(r=0.589,0.315 and 0.332,P=0.000),and HOMA-IR was negatively correlated with HDL-C(r=-0.188,P=0.000).Hs-CRP was positively correlated with fasting blood glucose,TG and waist circumference(r=0.168,0.172 and 0.338,P<0.05).HOMA-IR was positively correlated with hs-CRP(r=0.353,P=0.019).Conclusions HOMA-IR in patients with T2DM combined with MS is correlated with atherosclerosis,chronic systemic inflammation and TG/HDL-C ratio.

关 键 词：胰岛素抵抗指数 炎症指标 致动脉粥样硬化指数 2型糖尿病 代谢综合征 

分 类 号：R446.1[医药卫生—诊断学]