2型糖尿病患者游离脂肪酸水平与颈动脉内膜中层厚度的关系

Correlation of free fatty acids with carotid artery intima-media thickness in patients with type 2 diabetes

对70例2型糖尿病患者、22例糖耐量异常者与35例糖耐量正常者，行空腹血游离脂肪酸（fFFA）、口服糖耐量试验2h游离脂肪酸（2hFFA）及稳态模型胰岛素抵抗指数（HOMA-IR）、游离脂肪酸曲线下面积（AUC_FFA）和颈动脉内膜中层厚度（IMT）测定。2型糖尿病患者的平均HOMA-IR、fFFA、2hFFA、AUC_FFA、IMT水平分别为3．3±3．2、（0．55±0．20）mmol／L、（0．28±0．18）mmol／L、（0．83±0．34）mmol·L-1·h-1 和（0．12±0．05）cm，高于糖耐量正常者的1．9±1．3、（0．41±0．15）mmol／L、（0．12±0．10）mmol／L、（0．53±0．20）mmol·L-1·h-1和（0．09±0．03）cm。HOMA-IR、IMT与fFFA、2hFFA、AUC_FFA均呈正相关（均P〈0．05）。提示空腹及糖负荷后游离脂肪酸水平与胰岛素抵抗及糖尿病患者颈动脉IMT有一定相关性。

Seventy patients with type 2 diabetes （T2DM）, 23 subjects with impaired glucose tolerance （IGT） and 35 individuals with normal glucose tolerance （NGT） were recruited in the study. Fasting free fatty acids （fFFA） and postprandial free fatty acids （2 hFFA） after oral glucose tolerance test （OGTT） were measured; homeostasis model assessment of insulin resistance （HOMA-IR）, area under the curve of free fatty acids （AUC_FFA ） were calculated. The carotid artery intima-media thickness （IMT） was assessed by color ultrasonography. HOMA-IR, fFFA, 2 hFFA, AUC_FFA and IMT in T2DM group were 3.3 ± 3.2, （ 0. 55 ± 0. 20 ） mmol/L , （ 0. 28 ±0. 18）mmol/L, （0.83±0.34）mmol . L-1 . h-1 and （0.12± 0.05 ） cm, which were significantly higher than those in NGT group, respectively [ 1.9 ± 1.3, （ 0.41±0. 15）mmol/L,（0. 12 ±0. 10） mmol/L, （0. 53 ±0. 20）mmol .L-1 . h-1 and （0. 09 ±0. 03）cm, all P 〈 0. 05 ]. Both HOMA-IR and IMT were positively correlated with fFFA, 2 hFFA and AUC_FFA （ all P 〈 0. 05 ）. The results indicate that the levels of fasting and postprantial free fatty acid were related with insulin resistance and atherosclerosis of carotid artery.