透析患者红细胞脂肪酸谱与胰岛素抵抗的相关分析

Analysis of correlation between erythrocyte fatty acid profile and insulin resistance in dialysis patients

目的:研究血液透析和腹膜透析患者中红细胞脂肪酸谱与胰岛素抵抗的关系.方法:收集151例血液透析(血透组)和172例腹膜透析(腹透组)患者的血样,检测红细胞脂肪酸谱和评估胰岛素抵抗水平,并对二者之间进行t检验、多元Logistic回归和相关性分析.结果:血透组和腹透组的胰岛素抵抗发生比例分别为43%和32%,两组间脂代谢存在显著差异.根据胰岛素抵抗水平将透析人群分为非胰岛素抵抗组、轻度胰岛素抵抗组和严重胰岛素抵抗组.单因素分析表明体质指数、甘油三酯、高密度脂蛋白、二十四碳一烯酸、十四烷酸、二十二烷酸存在显著差异;Logistic多元回归分析表明透析人群甘油三酯对胰岛素抵抗有显著影响;相关性分析表明红细胞脂肪酸谱饱和脂肪酸与C-反应蛋白、IL-6明显相关.结论:血液透析和腹膜透析人群脂代谢存在显著差异,血液透析患者较腹膜透析患者更容易发生胰岛素抵抗.红细胞脂肪酸谱与透析患者胰岛素抵抗密切相关,摄入饱和脂肪酸过多可能会增加胰岛素抵抗.

Objective:To investigate the relationship between erythrocyte fatty acid profiles and insulin resistance in patients with hemodialysis and peritoneal dialysis.Methods:Blood samples were collected from 151 cases of hemodialysis(hemodialysis group)and 172 cases of peritoneal dialysis(hemodialysis group).Erythrocyte fatty acid profiles were detected and insulin resistance was evaluated.T-test,multivariate logistic regression and relevance analysis was performed.Results:The rate of insulin resistance were 43%and 32%in hemodialysis and peritoneal group,respectively.There was significant difference in lipid metabolism between the two groups.According to the level of insulin resistance,the dialysis patients were divided into non-,mild and severe insulin resistance group.Univariate analysis showed that there was significant difference in body mass index,triglyceride,high-density lipoprotein,tetradecanoic acid,docosanoic acid between groups.Logistic multivariate regression analysis showed that triglyceride had a significant effect on insulin resistance in dialysis patients.Correlation analysis showed that saturated fatty acids in erythrocyte fatty acid profiles were significantly correlated with c-reactive protein and IL-6.Conclusion:There was a significant difference in lipid metabolism between hemodialysis and peritoneal dialysis patients.Hemodialysis patients are more prone to insulin resistance than peritoneal dialysis patients.Erythrocyte fatty acid profile is closely related to insulin resistance in dialysis patients.Excessive intake of saturated fatty acids may increase insulin resistance.