联合检测血清胰岛素抵抗与脂质代谢相关指标对2型糖尿病合并高血压人群的探讨

Joint detection value of serum insulin resistance and related indexes of lipid metabolism in T2DM patients with hypertension

目的观察胰岛素抵抗与脂代谢对2型糖尿病(T2DM)合并高血压人群的影响。方法取1 708例健康体检者为对照组(Ⅰ组);1 697例T2DM患者为试验组,其中单纯T2DM 674例(Ⅱ组),T2DM合并高血压1 023例(Ⅲ组),采用全自动生化分析仪测血糖(GLU)、糖化血红蛋白(Hb A1c)、总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、载脂蛋白A1(ApoA1)、载脂蛋白B(ApoB);采用化学发光免疫分析仪测空腹胰岛素(FINS);计算稳态模型胰岛素抵抗指数(HOMA-IR)、胰岛素敏感指数(HOMA-ISI)、体质量指数(BMI)、血压、DM病史等临床资料。结果与Ⅰ组比较,Ⅱ组、Ⅲ组收缩压(SBP)、舒张压(DBP)及GLU、FINS、Hb A1c、HOMAIR、BMI、TC、TG、LDL-C、LDL-C/HDL-C、TG/HDL-C、ApoB上升;HOMA-ISI、HDL-C、ApoA1、ApoA1/ApoB下降;除HOMA-ISI、HDL-C、ApoA1、ApoA1/ApoB外,其余各指标Ⅲ组与Ⅱ组比较,有上升趋势。结论高血压、胰岛素抵抗、脂代谢紊乱是T2DM合并高血压患者发病的危险因素。

Objective To study the influence of insulin resistance and indexes of lipid metabolism in T2DM patients with hypertension. Methods 1 708 healthy people were enrolled as the control group（ Group I）; and 1 697 cases with T2DM were enrolled as the experimental group,1 023 of which were combined with hypertension（ Group III） and the other 674 were purely with T2DM（ Group II）. The blood sugar（ GLU）,glycosylated hemoglobin（ Hb A1c）,total cholesterol（ TC）,triglyceride（ TG）,high density lipoprotein cholesterol（ HDL-C）,low density lipoprotein cholesterin（ LDL-C）,apolipoprotein A1（ ApoA1） and apolipoprotein B（ ApoB） were determined with automatic biochemical analyzer; fasting serum insulin（ FINS） were determined by chemiluminescent immunoassay analyzer,and homeostasis model assessment of insulin resistance index（ HOMA-IR）,insulin sensitive index（ H0MA-ISI）,body mass index（ BMI）,blood pressure and medical history of DM were calculated.Results Compared to Group I,the systolic blood pressure（ SBP）,diastolic blood pressure（ DBP）,GLU,FINS,Hb A1 c,HOMA-IR,BMI,TC,TG,LDL-C,LDL-C / HDL-C,TG / HDL-C and ApoB of the Group II and III were higher; H0MA-ISI,HDL-C,ApoA1,ApoA1 / ApoB were lower. Compared to Group II,all indexes of Group III tend to rise exclude H0MA-ISI,HDL-C,ApoA1,ApoA1 / ApoB. Conclusion The T2DM patients with hypertension had higher blood pressure,disorder of insulin resistance and glucolipid metabolism.