Insulin sensitivity and the diffuseness of coronary artery disease in humans  

胰岛素敏感性与冠状动脉病变弥漫性的关系(英文)

作　　者：洪涛[1] 赵国安[1] 高炜[1] 霍勇[1] 朱国英[1] 

机构地区：[1]北京大学第一医院心内科,北京100034

出　　处：《Chinese Medical Journal》2002年第12期1886-1888,156,共3页中华医学杂志（英文版）

摘　　要：OBJECTIVE: To study the relationship between insulin sensitivity and diffuse coronary artery disease. METHODS: Ninety-two consecutive patients underwent coronary angiography were enrolled in the study. Relationships between the results of angiograms and both glucose tolerance and blood lipids were analyzed. RESULTS: The mean age of the 92 patients (70 males, 22 females) was 65.4 +/- 6.3 y. In the 78 patients diagnosed by angiography as coronary artery disease, diffuse lesion was more common in diabetic patients than in those without a diabetes history (12/13 vs 24/65, P = 0.00026). Fasting glucose [(6.06 +/- 2.43) x 10(-3) mol/L vs (4.80 +/- 1.47) x 10(-3) mol/L, P = 0.009], glucose levels at one hour [(12.37 +/- 4.38) x 10(-3) mol/L vs (9.10 +/- 3.97) x 10(-3) mol/L, P = 0.001], two hours [(11.12 +/- 5.64) x 10(-3) mol/L vs (7.49 +/- 4.29) x 10(-3) mol/L, P = 0.003] and three hours [(8.11 +/- 5.51) x 10(-3) mol/L vs (5.56 +/- 3.46) x 10(-3) mol/L, P = 0.020] after food were higher in patients with diffuse coronary disease than in those with non-diffuse coronary disease. Differences in the insulin sensitivity index (ISI) between the two groups was statistically significant (-4.36 +/- 0.52 vs -3.89 +/- 0.69, P = 0.003). The incidence of multiple-vessel disease in diabetic patients was higher than that in non-diabetic patients (12/13 vs 33/65, P = 0.00565). Glucose levels at two hours [(10.22 +/- 5.57) x 10(-3) mol/L vs (7.67 +/- 4.43) x 10(-3) mol/L, P = 0.034] and three hours [(7.90 +/- 5.47) x 10(-3) mol/L vs (5.22 +/- 2.79) x 10(-3) mol/L, P = 0.007] after food were higher in patients with multiple-vessel disease than in those with single-vessel disease. Impaired insulin sensitivity without a history of diabetes mellitus was commonly seen in patients with coronary artery disease. CONCLUSIONS: The diffuseness of coronary artery disease is associated with insulin sensitivity and blood glucose levels. Insulin resistance is a common phenomenon in non-diabetic patients.目的　研究胰岛素敏感性与冠心病患者冠状动脉病变弥漫性的关系。方法　 92例患者 (男 70例 ,女 2 2例 ,平均年龄 65 4± 6 3岁 )行择期冠状动脉造影 ,分析冠状动脉病变情况与糖耐量试验结果、血脂指标等的关系。结果　 78例经造影诊断冠心病的患者中 ,有糖尿病史者弥漫病变的比例高于无糖尿病史者 (12 / 13比 2 4 / 65 ,P =0 0 0 0 2 6) ,弥漫病变患者的空腹血糖 [(6 0 6± 2 4 3)× 10 3 mol/L比 (4 80± 1 4 7)× 10 3 mol/L ,P =0 0 0 9]、餐后 1小时 [(12 37± 4 38)× 10 3 mol/L比 (9 10± 3 97)× 10 3 mol/L ,P =0 0 0 1]、2小时 [(11 12± 5 64)× 10 3 mol/L比(7 4 9± 4 2 9)× 10 3 mol/L ,P =0 0 0 3]、3小时 [(8 11± 5 5 1)× 10 3 mol/L比 (5 5 6± 3 4 6)× 10 3 mol/L ,P =0 0 2 0 ]血糖水平均高于非弥漫病变患者 ,两组间的胰岛素敏感指数 (ISI)差异有显著性意义 (- 4 36± 0 5 2比 - 3 89±0 69,P =0 0 0 3)。糖尿病患者多支血管病变比例高于无糖尿病者 (12 / 13比 33/ 65 ,P =0 0 0 5 65 ) ,多支病变患者餐后 2小时 [(10 2 2± 5 5 7)× 10 3 mol/L比 (7 67± 4 4 3)× 10 3 mol/L ,P =0 0 34]、3小时 [(7 90± 5 4 7)× 10 3mol/L比 (5 2 2?

关 键 词：Insulin Resistance Aged Blood Glucose Coronary Circulation Coronary Disease FEMALE Humans HYPERINSULINISM LIPIDS Logistic Models Male Middle Aged 

分 类 号：R543.3[医药卫生—心血管疾病]