老年2型糖尿病患者微量白蛋白尿与胰岛素抵抗的关系

The relation between insulin resistance and microalbuminuria in elderly patients with type 2 diabetes mellitus

目的了解老年２型糖尿病患者的微量白蛋白尿（ＭＡＵ）与胰岛素抵抗的关系。方法对血压正常的３０例老年２型糖尿病合并ＭＡＵ患者与２６例未合并ＭＡＵ患者的空腹血糖、胰岛素、胰岛素敏感性指数（ＩＳＩ）和血脂等进行比较分析，并对所有患者的尿白蛋白排泄率（ＵＡＥＲ）与有关因素进行多元回归分析。结果２型糖尿病合并ＭＡＵ组ＩＳＩ（－４．９９±０．４８）显著低于未合并ＭＡＵ组（－４．７６±０．４８，Ｐ＜０．０５），而且ＩＳＩ与ＵＡＥＲ呈独立相关〔标准偏回归系数（β）＝－０．３９７，Ｐ＜０．０１〕。结论在血压正常的老年２型糖尿病患者中，胰岛素抵抗是ＭＡＵ的独立危险因素。

Objective To investigate the relation between insulin resistance and microalbuminuria in elderly patients with type 2 diabetes mellitus. Methods The fasting blood glucose(FBG), insulin(FIns), lipids, and insulin sensitivity index ln 1/(FIns×FBG) were measured in 30 normotensive type 2 diabetics elderly with microalbuminuria and in 26 normotensive type 2 diabetics elderly without microalbuminuria. Results The insulin sensitivity index in patients with microalbuminuria was significantly lower ( P <0 05) than in those without microalbuminuria.The insulin sensitivity index was independently correlated with urinary albumin excretion rate. Conclusions Insulin resistance is an independent risk factor for microalbuminuria in normotensive elderly patients with type 2 diabetes mellitus.