胰岛素抵抗住院患者颈动脉斑块相关危险因素分析

Carotid artery plaque and its predictive factors among inpatients with insulin resistance

目的:探讨胰岛素抵抗(IR)住院患者对颈动脉斑块的影响。方法 :选取住院患者240例,按胰岛素抵抗指数(HOMA-IR)分成2组,无IR组和IR组。按颈动脉中是否有斑块分为有斑块组与无斑块组。分析IR与住院患者颈动脉斑块的关系。结果:240例患者中,110例(45.8%)存在IR,144例(60.0%)有颈动脉斑块,IR组颈动脉斑块发生率是67.3%高于无IR组的53.8%,其中,IR人群发生颈动脉斑块是无IR人群的1.960倍(95%CI,1.119-3.431,P<0.05)。年龄(OR,1.045,95%CI,1.011-1.079,P<0.01)和LDL-C (OR,1.549,95%CI,1.004-2.390,P<0.05)是无IR人群颈动脉斑块的独立危险因素,而IR人群颈动脉斑块的独立危险因素除了年龄(OR,1.073,95%CI,1.027-1.121,P<0.01)和HDL-C(OR,0.178,95%CI,0.035-0.897,P<0.05)之外,还包括HOMA-IR (OR,1.732,95%CI,1.131-2.651,P<0.05)。结论:IR住院患者颈动脉斑块发生率高。IR是颈动脉斑块形成的独立危险因素。除了年龄和高血脂,HOMA-IR也参与了住院患者颈动脉斑块的形成。IR的筛查可作为预防颈动脉斑块的指标。

Objective:To investigate the correlation between insulin resistance(IR)and carotid artery plaque in inpatients and its predictive factors.Methods:240inpatients were divided into no IR group and IR group by homeostasis model assessment of insulin resistance(HOMA-IR).And according to whether with carotid artery plaque or not,patients were separated into plaque group and no plaque group.Aims to analysis the relationship between IR and the predictive factors of plaque in inpatients.Results:Among240patients,there were110with IR,and144with carotid artery plaque,accounting for48.5and60.0percent,respectively.The prevalence of plaque in IR group was67.3percent,higher than no IR group whose prevalence was53.8percent.The incident carotid artery plaque events in patients with IR were1.960(95%CI,1.119-3.431,P<0.05)times higher than those without IR.Age(OR,1.045,95%CI,1.011-1.079,P<0.01)and LDL-C(OR,1.549,95%CI,1.004-2.390,P<0.05)were significant predictive factors for no IR subjects.Age(OR,1.073,95%CI,1.027-1.121,P<0.01)and HDL-C(OR,0.178,95%CI,0.035-0.897,P<0.05)were significantly associated with the formation of plaque in IR group.Apart from age and HDL-C,HOMA-IR played an important role in IR group with plaque.Conclusions:The prevalence of plaque in insulin resistance inpatients was high.IR was an important factor for inpatients with carotid artery plaque.Age,HOMA-IR and different glycemic status were independent risk factors for insulin resistance inpatients.Except age and high plasma lipid,HOMA-IR was an independent predictor of plaque.IR can be used as a screening standard for the prevention of carotid artery plaque.