老年2型糖尿病患者高甘油三酯血症与胰岛素抵抗及糖代谢的关系

The relationship of hypertriglyceridemia with glucose metabolism in the elderly with type 2 diabetes mellitus

目的了解老年2型糖尿病患者高甘油三酯 (TG)血症与胰岛素抵抗及糖代谢的关系 ,探讨降脂药物舒降之对胰岛素抵抗及糖代谢的影响。方法对22例老年2型糖尿病伴高TG血症患者与26例TG正常患者的空腹血糖 (FBG)、空腹胰岛素 (Flns)、胰岛素敏感指数 (ISI)、TG及糖化血红蛋白 (HbA1c)进行比较分析 ,对14例伴高TG血症患者作治疗前后动态观察。结果老年2型糖尿病伴高TG血症者Flns显著高于TG正常者。ISI显著低于TG正常者 ,用舒降之治疗3个月后,患者血TG、FBG、HbA1c、Flns有明显下降 ,ISI明显升高。结论伴高TG血症的老年2型糖尿病患者存在明显的高胰岛素血症和胰岛素抵抗 ,舒降之除能改善脂代谢紊乱外还能提高胰岛素的敏感性 ,有助于纠正糖代谢异常。

Objective To investigate the relationship of hypertriglyceridemia (HTG) with glucose metabolism in the elderly with type 2 diabetes mellitus. Methods FBG, Fins, ISI, TG and HbA1c were measured in 48 old patients with type 2 diabetes mellitus (22 of them had HTG). Results The ISI of patients with HTG was significantly lower than those with normal blood TG level. After the antihyperlipidemic treatment, the TG, FBG, Fins and HbA1c of 14 patients were reduced, while ISI increased. Conclusion Type 2 diabetes mellitus patients with HTG had significant hyperinsulinemia and insulin resistance. Antihyperlipidemic treatment had additional effect of correcting glucose metabolism disturbance.