无糖尿病中老年脑梗死患者胰岛素抵抗的临床研究

Clinical analysis of insulin resistance in the non-diabetic middle-aged and old patients with brain infarction

目的探讨胰岛素抵抗(IR)与无糖尿病的中老年人的脑梗死之间的关系。方法检测年龄≥45岁且无糖尿病的30例脑梗死患者和12例非脑梗死患者(对照组)的空腹血糖、胰岛素、皮质醇、生长激素、C肽和血脂浓度。采用稳态评估法(HOMA)得出的胰岛素抵抗指数(HOMA-IR)作为判断IR的指标。结果脑梗死组的年龄、收缩压、空腹胰岛素水平和HOMA-IR高于对照组(P<0.05),而且有更多的人既往有高血压史(P<0.05)。多因素Logistic回归分析显示HOMA-IR是脑梗死发病的独立危险因素,且多元回归分析显示HOMA-IR与空腹血糖和胰岛素相关。结论胰岛素抵抗与无糖尿病中老年人的脑梗死密切相关,且它可能通过复杂的机制参与脑梗死的发生。

Objective To explore the relationship between insulin resistance and brain infarction in non-dia- betic middle-aged and older patients. Methods Fasting blood glucose, insulin, cortisol, growth hormone, C- peptide and blood lipids were measured in 30 patients with brain infarction and 12 patients without brain infarction as control subjects all of whom were older than 45 years and non-diabetic. Insulin resistance was determined by HOMA-IR. Resuits The levels of the age, systolic blood pressure, fasting insulin and HOMA-IR in patients with brain infarction were higher than those in patients without brain infarction as control subjects （ P 〈 0.05 ）, and there were more patients with history of hypertension in those with brain infarction （ P 〈 0.05 ）. A multivariate logistic regression analysis revealed that HOMA-IR was the independent risk factor for brain infarction, and fasting blood glucose and insulin were correlated with HOMA-IR. Conclusion Insulin resistance was closely correlated with brain infarction in non-diabetic middle-aged and older people,which is possibly involved in the occurrence of brain infarction .