胰岛素抵抗和微量白蛋白尿关系的探讨

STUDY ON RELATIONSHIP BETWEEN URINARY ALBUMIN EXCRETION RATE AND INSULIN RESISTANCE IN POSTPRANDIAL HYPERGLYCEMIC SUBJECTS

目的 :探讨餐后高血糖人群中微量白蛋白尿和胰岛素抵抗的关系及其影响因素。方法 :将以微量血糖筛查餐后 2 h血糖超过 6 .6 7mm ol/ L 参试者 739例 ,分为正常和微量白蛋白尿两组。结果 :微量白蛋白尿组的年龄、BMI、WHR、SBP、DBP、FBG、AU CBG、HOMA- IR指标均较高 ,两组比较 ,有显著性差异 (P <0 .0 5或 P <0 .0 1) ,而性别、HR、HOMA- IS、FINS、AUCINS和 TG均无显著性差异 (P >0 .0 5 )。在以 U AER为二分变量 ,其它各指标为协变量的非条件 L ogistic回归方程中 ,DBP、 AUCBG、 HOMA- IR变量能进入回归方程 ,而以 HOMA - IR为应变量 ,以年龄、 BMI、 WHR、 SBP、 DBP和 UAER为自变量建立多元线性回归模型 ,结果表明 U AER、 BMI和 WHR对 HOMA- IR有预报作用。结论 :1影响微量白蛋白尿的因素较多 ,其中最主要的 3个因素依次为 HOMA- IR、 DBP、 AU CBG。 2 U AER临床可以预测 IR的存在。

Objective To investigate relationship between urinary albumin excretion rate (UAER) and insulin resistance in postprandial hyperglycemic subjects Method:739 participants were elected with postprandial finger tip blood sugar ≥ 6 67 mmol/L The participants were divided into two groups: normal and microalbuminuria group Results:Age?BMI?WHR ?SBP?DBP ?FBG?AUC BG ?HOMA IR in microalbuminuria group were higher than those in normalbuminuria group significantly Logistic regression analysis was performed with UAER as dependant variable, and age?BMI?WHR?SBP?DBP?AUC BG ?HOMA IR as independent variable The results showed that DBP?AUC BG ?HOMA IR entered regression equation Linear multivariable regression was performed too,with HOMA IR as dependant variable and age?BMI?WHR?SBP?DBP?UAER as independent variables The results showed that UAER?BMI and WHR could predict the development of HOMA IR Conclusion:①There are many factors which effect UAER, the most important factors are HOMA IR?DBP?AUC BG ?②UAER can predict the existence of insulin resistance in clinic practice