调脂治疗对血浆胰岛素水平的影响

Lipid-lowering Treatment on Plasma Insulin Level

为了探讨调脂治疗对 2型糖尿病病人胰岛素抵抗的作用 ,选择血糖、血压控制稳定并伴有脂代谢紊乱的 2型糖尿病患者 84例 ,根据血脂异常的不同 ,4 9例用辛伐他汀 (商品名舒降之 )治疗 ,35例用非诺贝特 (商品名力平之 )治疗 ,为期12周 ,降糖、降压治疗维持不变。治疗前后分别检测体质量指数、腰臀围比、血压、糖化血红蛋白、空腹血浆胰岛素及血清总胆固醇、总三酰甘油、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇水平。结果 :治疗后 ,血清总胆固醇、低密度脂蛋白胆固醇、总三酰甘油水平均明显下降 (P <0 .0 1) ;非诺贝特组高密度脂蛋白胆固醇治疗后显著升高 (P =0 .0 37) ;空腹胰岛素显著下降 (P <0 .0 1)。辛伐他汀组和非诺贝特组治疗后的空腹胰岛素水平比较差异无统计学意义 (P >0 .0 5 )。提示 :2型糖尿病病人通过有效的调脂治疗后 ,胰岛素抵抗有所改善。

The aim was to approach the effect of lipid-lowering treatment on insuli n resistance in patients with type 2 diabetes mellitus. Eighty-four type 2 diab etic patients associated with dyslipidemia were treated by antihyperlipoidemics. 49 patients were treated with 20 mg simvastatin and 35 patients were treated wit h 0.2 g fenofibrate per day. The antihyperglycemic and antihypertensive ther apies were maintained. Before and after the treatment, all of patients w ere examined body mass index(BMI), waist-line/hip-line rate(WHR), blood pressu re, glycosylated hemoglobic (HbA1c), plasma fasting insulin (FINS), total choles terol(TC), total triglyceride (TG), high-density lipoprotein cholesterol (HDL- C) and low-density lipoprotein cholesterol(LDL-C). After 12 weeks of follow up ,the TC, TG, and LDL-C levels decreased obviously(P<0.01). HDL-C level in creased obviously in the lipanthyl group (P=0.037). The plasma fasting insul in level decreased from (10.93±5.03) to (9.28±4.26) IU·L -1 (P<0.01 ). There were no difference in the fasting plasma insulin level when the simvast atin treated group were compared with the fenofibrate treated group. It suggests that the resistance of insulin improves lipid-lowering treatment in type 2 dia betic patients.