动脉硬化性脑梗死患者的胰岛素抵抗与血脂异常关系的研究

Study of the Relationship Between Insulin Resistance and Blood-lipid Abnormality in Patients with Arteriosclerotic Cerebral Infarction

【目的】探讨动脉硬化性脑梗死(ACI)患者急性期和恢复期的胰岛素抵抗(IR)与血脂异常的关系。【方法】分别测定91例ACI患者急性期和恢复期的空腹血清葡萄糖(FSG)、胰岛素(FINS)、总胆固醇(CHO)、甘油三酯(TG)、低密度脂蛋白(LDL)、高密度脂蛋白(HDL)、脂蛋白a(LP(a))、载脂蛋白AⅠ(ApoAⅠ)和载脂蛋白B(ApoB)的浓度。胰岛素敏感性指数(ISI)采用FSG与FINS乘积的倒数的自然对数。并以40例健康同龄人作为对照。【结果】ACI患者急性期和恢复期的FSG、FINS、TG、CHO、LDL、ApoB、LP(a)的血清浓度显著高于健康对照组,ISI、ApoAⅠ和HDL水平显著低于健康对照组;急性期和恢复期的ISI与血清TG、ApoB浓度和BMI呈负相关,与血清HDL和ApoAⅠ浓度呈正相关,ISI与血清LDL、Lp(a)浓度不相关。体重指数与ISI负相关,与FINS浓度正相关。【结论】ACI患者的IR可致高甘油三酯血症、高ApoB血症和HDL血症。

【Objective】To explore the relationship between insulin resistance（IR） and blood-lipid abnormality in acute and recovery phases of patients with arteriosclerotic cerebral infarction（ACI）.【Methods】The free serum concentrations of glucose and insulin and blood-lipid were measured in 91 patients with ACI and 40 healthy control subjects.Insulin sensitivity index（ISI） was estimated by the negative natural logarithm of the verse of fasting serum glucose and insulin product.【Results】The free serum concentrations of glucose、insulin、CHO、TG、LDL、LP（a）、ApoAⅠand ApoB in the acute and recovery phases of the patients with ACI were much higher than those in the healthy control subjects（P〈0.01）,while the levels of the ISI、ApoAⅠand HDL in the acute and recovery phases of the patients with ACI were much lower than those in the healthy control subjects（P〈0.01）.The ISI in the acute and recovery phases of the patients with ACI was negatively associated with the levels of the TG、ApoB and BMI and was positively associated with the free serum concentrations of the ApoAⅠ and HDL.The ISI in the acute and recovery phases of the patients with ACI was not associated with the free serum concentrations of LDL and LP（a）.BMI was negatively associated with the ISI and was positively associated with the free serum concentration of insulin in the patients with ACI.【Conclusion】Insulin resistance in patients with ACI may cause in increased serum concentrations of TG and ApoB and decreased serum concentrations of HDL.