非糖尿病腹膜透析患者胰岛素抵抗及脂代谢紊乱相关分析

Insulin resistance and dyslipidemia in non-diabetic peritoneal dialysis patients

目的观测非糖尿病腹膜透析患者胰岛素抵抗和脂代谢紊乱发生情况及分析其相关影响因素。方法入选非糖尿病透析龄大于3个月规律连续不卧床腹膜透析(CAPD)患者48人,在相同条件下测定其身高、体重、体重指数(BMI),空腹血糖、空腹胰岛素及血脂等生化指标,以生物素-亲和素酶联免疫吸附法(ABC-ELISA)测定脂联素、瘦素、抵抗素等脂质因子。结果非糖尿病腹透患者48人(男20,女28)稳态胰岛素抵抗指数(HOMA-IR)为6.32±8.97,其中4位患者在透析过程中发展为糖尿病。根据IR中位数2.59分组,IR≥2.59组(n=24)与<2.59组(n=24)两组比较发现在BMI、三酰甘油、铁蛋白和脂联素、瘦素存在显著差异(P<0.05)。相关分析结果表明IR与铁蛋白(P<0.01)、血脂(胆固醇、三酰甘油)分别成正相关(P<0.05)。结论非糖尿病腹透患者存在胰岛素抵抗,肥胖、高三酰甘油血症、脂联素、瘦素等因素与胰岛素抵抗相关。

Objective To observe insulin resistance （IR） and dyslipidemia in non-diabetic peritoneal dialysis patients and to analyze the factors related to IR. Methods Forty-eight non-diabetic continuous ambulatory peritoneal dialysis （CAPD） patients were enrolled. Parameters including height, weight, body mass index, fast glucose, insulin and serum lipid were measured in the same situation. Leptin, adiponectin and resistin were measured by ABC-ELISA. Results The average HOMA-insu- lin resistance was 6.32± 8. 97, four of the 48 patients were progressed to diabetes. The patients were divided into two groups according to the IR medium 2. 59. There were significant differences in BMI, serum triglyceride, ferritin, adiponectin and leptin level （P〈0. 05） between these two groups. There was positive relationship between IR and ferritin （P〈0. 01）, and also between serum lipid （cholesterol, triglyceride） and IR as well （P〈0. 05）. Conelusions There was IR and dyslipidemia in non-diabetic PD patients, overweight, hypertriglyceridemia, adiponectin and leptin were related to IR.