胰岛素抵抗与冠状动脉病变的关系分析

Association between insulin resistance and coronary artery disease

目的探讨胰岛素抵抗在冠状动脉病变发生发展中的作用。方法选择行冠状动脉造影术的非糖尿病患者204例,根据冠状动脉造影结果将其分为冠心病组(136例)和对照组(68例),分析患者胰岛素抵抗指数(HOMA-IR)、空腹血清胰岛素水平与冠心病发生的关系及冠状动脉狭窄程度的关系。结果校正了性别、年龄、体重指数等影响因素后,冠心病组IR和血清胰岛素水平高于对照组(P<0．05),logistic回归分析显示IR、空腹胰岛素水平与冠心病发生呈正相关,OR值分别为2．03和1．60(P<0．05);不同程度冠状动脉狭窄组IR、空腹胰岛素水平有差异(P<0．05),线性回归分析显示IR、空腹胰岛素水平与冠状动脉狭窄积分呈正相关,β值分别为0．57和0．45。结论胰岛素抵抗是冠状动脉病变的独立危险因素。

Objective To study the effect of insulin resistance on the development of coronary artery disease （CAD）. Methods In total, 204 nondiabetic inpatients diagnosed by elective coronary angiography were selected in the study and divided into CAD and control groups. Relationship between insulin resistance assessed by homeostasis model （HOMA-IR） and fasting serum level of insulin and occurrence of CAD and the extent of stenosis of coronary arteries was analyzed. Results IR and serum level of insulin were significantly higher in CAD group than those in control group （ P 〈 0.05 ） adjusted for sex, age, body mass index （BMI）, and so on. IR and fasting serum level of insulin correlated positively to occurrence of CAD by logistic regression, with ORs of 2. 03 and 1.60 （P 〈 0. 05）, respectively. There was significant difference in fasting serum level of insulin between groups with varied stenosis of coronary arteries （ P 〈 0.05 ）. Linear regression analysis showed that IR and fasting serum level of insulin correlated positively to the score of coronary stenosis, with coefficients of correlation （α） of 0. 57 and 0.45 （ P 〈 0. 05 ）, respectively. Conclusions IR was an independent risk factor for CAD.