2型糖尿病胰岛素抵抗与α-脂蛋白、冠心病的关系

Relationship between insulin resistance and lipoprotein (α), coronary heart disease in type 2 diabetes mellitus

目的 探讨胰岛素抵抗与小脂蛋白［Ｌｐ（α）］和冠心病的关系。方法 以酶联免疫法对照观察了糖尿病患者胰岛素抵抗组和非胰岛素抵抗组的Ｌｐ（α）及其他脂代谢指标和冠心病的患病率。结果 胰岛素抵抗组和非胰岛素抵抗组的空腹血糖、糖基化血红蛋白和高密度脂蛋白胆固醇无显著差异（Ｐ＞０．０５），而两组总胆固（Ｐ＜０． ０５）、甘油三酯（Ｐ＜０．０５）、低密度脂蛋白胆固醇（Ｐ＜０．０５）有显著差异，特别是Ｌｐ（α）值（Ｐ＜０． ０１）和冠心病的患病率（Ｐ＜０．０１），胰岛素抵抗组较非胰岛素抵抗组极显著升高。结论 在２型糖尿病患者中，胰岛素抵抗可能是导致脂代谢紊乱、Ｌｐ（α）升高和冠心病发生的主要因素之一。

Objective To study the relationship between insulin resistance (IR) and lipoprotein (a) [LP(α)], coronary heart disease (CHD). Methods Plasma LP(α) was determined by enzyme-linked immunoassay (ELISA) in type 2 diabetic patients with IR (group A) and those without IR (group B). Results There was no significant difference in the levels of FBG, HbAlC and HDL- ch between the group A and group B (P>0.05). However, the levels of Teh, TG, LDL-ch, LP (α) and the prevalence of CHD were significantly higher in the group A than those in the group B (P<0.05; P<0.05; P<0.05; P<0.01; P<0.01, respec- tively) . Conclusion Insulin resistance might be an important factor responsible for the metabolic disorder of lipoproteins and CHD in type 2 diabetes mellitus, as well as the increase of LP (α).