不同糖耐量人群胰岛素敏感性与动脉粥样硬化性疾病危险因子的相关关系分析

The correlation of insulin sensitivity and the risk factors of atherosclerosis

目的探讨不同糖耐量人群胰岛素敏感性与动脉粥样硬化性疾病危险因子的相关关系。方法319例健康体检者餐后2小时血糖>6.67mmolL者,行OGTT检查,根据1997年ADA糖尿病诊断标准,分为糖尿病(DM)组、糖耐量低减(IGT)组、空腹血糖受损(IFG)组及正常糖耐量(NGT)组。测量身高、体重、腰臀围、血压,测定血糖、血脂、血胰岛素及尿微量白蛋白,计算体重指数(BMI)及胰岛素敏感指数(ISI)。结果IGT组、DM组的平均年龄、平均收缩压明显高于NGT组,IFG、IGT、DM组的ISI明显低于NGT组,DM组的ISI低于IGT组。IGT、DM组的平均胆固醇(CHO)明显高于NGT组。多因素回归分析BMI、餐后2小时血糖、餐后2小时胰岛素、甘油三酯(TG)与ISI呈负相关。结论ISI随着NGT向IGT、IFG及DM的发展逐渐下降,冠心病的危险因子也伴随出现。对于DM及其大血管并发症的防治,应从IGT和IFG阶段开始。

Objective To investigate the relation between insulin sensitivity and the risk factors of atherosclerosis. Methods 319 healthy subjects were subjected to the measurement of two hours postprandial serum glucose. If the serum glucose was higher than 6.67 mmol/L, the subjects were let to take the OGTT. According to diagnostic criteria of diabetes made by ADA in 1997, they were divided into four groups: DM, IGT, IFG and NGT. the subjects were measured in height,weight,waist and blood pressure. Serum glucose,lipid,insulin and microurinalbumin were measured as well. BMI and ISI were then calculated. Results The average age,systolic blood pressure in IGT and DM groups were remarkably higher than those in NGT; ISI in IFG,IGT and DM groups were lower than in NGT group. Cholesterol in IGT and DM groups was higher than in NGT group. ISI was negatively related to BMI,postprandial serum glucose,postprandial serum insulin and triglyceride. Conclusion With the developmental progress from NGT to IFG,IGT and DM,ISI reduces gradually, and the risk factors of aterosclerosis emerge. Hence the measures to prevent and treat DM and its vascular complictions should be started early at the IFG and IGT stages.