胰岛素抵抗与冠心病危险因素的相关性分析

Relationship between Insulin Resistance and Risk Factors of Coronary Artery Disease

目的:探讨胰岛素抵抗(IR)与冠心病常见危险因素之间的关系。方法:采用回顾性研究,整理自2005年4月—2006年8月住院并行冠状动脉造影确诊冠心病的患者资料,分析胰岛素抵抗与冠心病常见危险因素之间的关系。结果:IR组患者高血压发生率、收缩压、体质量指数(BMI)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、空腹血糖(FPG)、空腹胰岛素(FINS)、尿酸(UA)高于胰岛素敏感(IS)组,高密度脂蛋白胆固醇(HDL-C)低于IS组(P<0.05或P<0.01);经Spearman相关分析表明HOMA-IR与患者的高血压、收缩压、TG、FINS、FPG、BMI和UA水平呈正相关(r在0.283～0.937,P<0.05或P<0.01),与HDL-C呈负相关(r=-0.455,P<0.01);经多元逐步Logistic回归分析表明HOMA-IR与高血压、收缩压、TG、FINS、FPG、BMI、UA和HDL-C相关。结论:IR患者存在冠心病危险因素的聚集趋势,常合并高血压、肥胖、血脂代谢紊乱、血糖和胰岛素代谢紊乱,IR可能是冠心病的危险因素。

Objective： To explore the relationship between insulin resistance and risk factors of coronary artery disease. Methods： All data were taken from the hospitalized coronary artery disease cases operated on coronary angiography from April. 2005 to August. 2006. The relationship between insulin resistance and risk factors was analyzed by retrospective study. Results： Hypertension, systolic blood pressure, and the levels of TG, LDL-C, FPG, FINS and UA in IR group were higher than that in IS group （P 〈 0.05 or P 〈 0.01 ）. The level of HDL-C in IR group was lower than that in IS group （P 〈 0.01 ）. Positive correlations were found between HOMA-IR and hypertension, systolic blood pressure, TG, FINS, FPG, BMI and UA（r 0.283-0.937, P 〈 0.05 or P 〈 0.01 ）, and a negative correlation between HOMA-IR and HDL-C （r = -0.455 ,P = 0.007） by Spearman correlation analysis. Multiplicity logistic regression model analysis showed correlations between HOMA-IR and hypertension, systolic blood pressure ,TG, FINS, FPG, BMI, UA and HDL-C. Conclusion： The IR patients have concentrated trend of coronary artery disease, and always complicate with hypertension, obesity, blood lipid metabolic dysfunction,glucose and insulin metabolic dysfunction. IR may be a risk factor for coronary artery disease.