老年2型糖尿病患者颈动脉内膜中层厚度与胰岛素抵抗的相关性研究

Study on the Correlation Between Carotid Intima-media Thickness and Insulin Resistance in Elderly Patients with Type 2 Diabetes Mellitus

【目的】探讨老年2型糖尿病（T2DM）患者颈动脉内膜中层厚度（IMT）与胰岛素抵抗（IR）的关系。【方法】将来本院门诊、住院的T2DM、高血压患者共171例分为血糖正常的高血压组（n＝61）、T2DM组（n＝48）、T2DM合并高血压组（n＝62），另以健康体检正常者（n＝62）为对照组。分别检测空腹血糖（FPG）、空腹胰岛素（FINS）、糖化血红蛋白（HBA1c）、尿酸（UA）、血脂等生化指标和 IMT，并结合临床资料进行分析。【结果】血糖正常高血压组与T2DM组的IMT无显著性差异（P＞0．05）；无论是否合并T2DM，非高血压者的IMT均显著低于高血压组（P＜0．01）；相关分析显示：IMT和 FPG、HBA1c、UA、血浆三酰甘油酯（TG）、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）均无显著相关性，而与胰岛素敏感指数显著相关（相关系数为0．293，P＜0．05）。【结论】胰岛素抵抗是老年T2DM患者颈动脉 IMT增厚的独立危险因素。

[Objective]To explore the correlation between carotid intima-media thickness（IMT）and insulin resist-ance in elderly patients with type 2 diabetes mellitus（T2DM）.[Methods]Totally 171 patients with diabetes mellitus or hy-pertension in our hospital were divided into hypertension group（n=61）,T2DM group（n=48）and T2DM with hyper-tension group（n=62）.Other 62 healthy people were selected as normal group.The biochemical indicators such as fast-ing plasma glucose（FPG）,fasting insulin（FTINS）,glycosylated hemoglobin（HBA1 c）,uric acid（UA）,blood lipids and IMT were measured.The above indexes combined with clinical data were analyzed.[Results]There was no significant difference in IMT between normal plasma glucose group and T2DM group（P〉0.05）No matter that patients were com-plicated with or without T2DM,IMT of non-hypertension patients was significantly lower than that of hypertension pa-tients（P〈0.01）.Correlation analysis showed that IMT was not significantly associated with FPG,HBA1c,UA,plas-ma triglyceride（TG）,total cholesterol（TC）,high density lipoprotein cholesterol（HDL-C）and low density lipoprotein cholesterol（LDL-C）,but significantly associated with insulin resistance index（ISI）（coefficient was 0.293,P〈0.05）.[Conclusion]Insulin resistance is an independent risk factor of the increased carotid IMT in elderly patients with T2DM.