男性2型糖尿病合并痛风患者胰岛素敏感指数的变化及意义

Changes and Significance of Insulin Sensitivity Index in Male Patients with Type 2 Diabetes Mellitus Complicated with Gout

【目的】探讨男性2型糖尿病（type2diabetesmellitus，T2DM）合并痛风患者胰岛素敏感指数（ISI）的变化及临床意义。【方法】选择2014年6月至2015年10月在本院接受治疗的T2DM男性患者为观察对象，根据其是否合并痛风分为痛风组和非痛风组。比较两组患者ISI、脂联素（Adiponectin，APN）和C反应蛋白（C-reactiveprotein，CRP）水平；比较不同临床特征患者ISI、APN和CRP的水平差异，分析ISI与APN、CRP的相关性。【结果】痛风组患者ISI和APN水平较非痛风组低，而CRP水平较非痛风组高，差异具有统计学意义（Pd0．05）；年龄≥65周岁、体质量指数（BMI）较大、合并高血压、合并高尿酸血症的患者ISI和APN水平较低（Pd0．05）；年龄≥65周岁、合并高血压、合并高尿酸血症患者的CRP水平较高（P〈0．05），而不同BMI的患者CRP水平无明显差别（P〉0．05）；ISI水平与APN、CRP水平均呈明显正相关（P〈0．05）。【结论】男性T2DM合并痛风患者的ISI水平较低，其与患者的年龄、BMI等明显相关，且与APN及CRP水平存在明显的相关性。

[Objective] To investigate the changes and clinical significance of insulin sensitivity index （ISI） in male patients with type 2 diabetes mellitus （T2DM） complicated with gout.[Methods]T2DM male patients who received treatment in our hospital from June 2014 to October 2015 were selected as observation subjects and divided into gout group and non gout group according to whether they were combined with or not. Com- parison of ISI, adiponectin （APN） and C reactive protein （CRP） level of the two groups of patients were made; Differences of clinical characteristics of ISI, APN and CRP levels were compared, and the correlation between ISI and APN, CRP was analyzed.[Results]The levels of ISI and APN in the patients with gout were lower than those in the non gout group, while the CRP level was higher than that in the non gout group, and the difference was statistically significant （ P 〈0.05） ; levels of ISI and APN were lower to those whose age was equal to or more than 65 years old with larger BMI （body mass index） and combined with hypertension and hyperuricemia （ P 〈0.05） ; CRP levels of patients with different BMI levels were not significantly differ- ent （ P 〉0.05） ; the level of ISI was positively correlated with the those of APN and CRP （ P 〈0.05）.[Conclusion] The ISI level of T2DM male patients complicated with gout tends to be rather low, which is obviously correlated with patients age and BMI, and APN and CRP levels herewith are closely related.