2型糖尿病患者颈动脉粥样硬化与胰岛素抵抗的相关分析

The correlation analysis of carotid atherosclerosis and insulin resistance in patients with 2-type diabetes mellitus

目的探讨2型糖尿病患者颈动脉粥样硬化与胰岛素抵抗的相关性。方法将63例2型糖尿病患者分为血糖控制良好组30例（糖化血红蛋白≤7％）及控制不良组33例（糖化血红蛋白〉7％）；选取健康者35例为对照组。超声检查三组颈动脉内-中膜厚度（IMT），观察斑块发生率。同时测量空腹血糖和空腹血清胰岛素，并计算胰岛素抵抗指数（HOMA—IR）。结果血糖控制不良组HOMA—IR、IMT及斑块发生率均高于血糖控制良好组（P〈0．05），且IMT与空腹血糖、HOMA—IR呈正相关（r=0．624，r=0．458，P〈0．05）。结论2型糖尿病患者高HOMA—IR组较低HOMA—IR组颈动脉粥样硬化病变更明显。

Objective To investigate the relationship between insulin resistance and carotid atherosclerosis in patients with 2 - type diabetes mellitus（2DM）. Methods Sixty- three patients with 2DM were divided into two groups according to glycosylated hemoglobin level： DMA group consisted of thirty cases whose glycosylated hemoglobin was less than 7 %, while DMB group consisted of thirty - three cases whose glycosylated hemoglobin was more than 7 %, thirty - five healthy people were served as control. Carotid artery （CA） intima- media thickness （IMT） was examined by ultrasound, the plaque incidence of CA was observed, fasting blood glucose （FBG） ,fasting insulin（Fins） were measured, and insulin resistance index（HOMA- IR） was calculated. Results IMT, HOMA- IR and plaque incidence of CA in DMB group were higher than that of DMA group （ P 〈 0.05）, while there was a positive correlation between IMT, HOMA - IR and FBG（ r = 0. 624 and r = 0. 458, respectively; P 〈 0.05 ）. Conclusion Carotid atherosclerotic plaque in high HOMA- IR group is more significant than that in low HOMA- IR group in patients with 2- type diabetes mellitus.