糖耐量减低患者胰岛素抵抗与血脂变化的临床观察

Clinical observation of insulin resistance and blood lipid changes in patients with impaired glucose tolerance

目的 探讨糖耐量减低（IGT）患者胰岛素抵抗和血脂的相关性.方法 选择2011年1月～2013年1月来本院下属5家社康就诊的120例IGT患者作为实验组,选取同时期120例糖耐量正常志愿者作为对照组,分别测定两组入选者空腹胰岛素（FIns）水平、餐后2h胰岛素（2 h Ins）水平、三酰甘油（TG）、总胆固醇（TC）、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）、游离脂肪酸（FFA）等各项指标水平,并计算两组入选者胰岛素抵抗指数（HOMA-IR）、胰岛素分泌指数（HOMA-3）以及葡萄糖处置指数（GDI）等.结果 实验组TG、FFA、空腹血糖均显著高于对照组,HDL-C明显低于对照组,差异均有统计学意义（P＜0.05）,而两组TC、LDL-C差异无统计学意义（P＞0.05）;实验组HOMA-IR、FIns、2 h Ins水平显著高于对照组,GDI显著低于对照组,差异均有统计学意义（P＜0.05）.结论 IGT患者有明显的胰岛索抵抗以及高血脂症状,因此临床中要注意防止出现高脂血症.

Objective To explore the correlation between insulin resistance and blood lipid in patients with impaired glucose tolerance （IGT）. Methods 120 patients with IGT treated in 5 community health service centers affiliated to our hospital from January 2011 to January 2013 were selected as experimental group.Another 120 volunteers with normal glucose tolerance in the same period were chosen as control group.The indexes like fasting insulin（Fins） level,2 h postprandial insulin（2 h Ins） level,triglyceride（TG）,total cholesterol（TC）,high density lipoprotein cholesteml（HDL-C）,low density lipoprotein cholesterol （LDL-C） and free fatty acid （FFA） were tested in both groups in order to calculate the homeostasis model assessment of insulin resistance （HOMA-IR）,homeostasis model assessment of [3 cell secretion （HOMA-13） and glucose disposal index （GDI）. Results The levels of TG,FFA, and fasting blood-glucose in the experi- mental group were remarkably higher than those of the control group,while the value of HDL-C was obviously lower than that of the control group with statistical differences （P〈0.05）The differences of TC and LDL-C between the two groups were not statistically significant （P〉0.05）.The levels of HOMA-IR, Fins and 2 h Ins in the experimental group were observably higher than those of tile control group,but the GDI was lower than that of the control group,the differences were statistically significant （P〈0.05）. Conclusion Due to obvious insulin resistance and hyperlipidemia in patients with IGT,the prevention of its occurrence should be paid a great attention in clinic.