空腹血糖、空腹胰岛素、胰岛素抵抗指数和同型半胱氨酸水平对2型糖尿病合并缺血性脑卒中发生的影响

Effects of FBG, FINS, HOMA-IR, and Hcy on Occurrence of Ischemic Stroke in Type 2 Diabetes Mellitus

目的:分析空腹胰岛素(FINS)、空腹血糖(FBG)、同型半胱氨酸(Hcy)及胰岛素抵抗指数(HOMA-IR)对2型糖尿病(T2DM)合并缺血性脑卒中(IS)发生的影响。方法:选取T2DM患者85例,根据患者是否伴有IS分为T2DM+IS组(44例)和T2DM组(41例),另选取同期于本院健康体检的志愿者30例为对照组。比较3组体质量指数(BMI)、血压、血糖及血脂4项指标的差异,并计算HOMA-IR。采用多因素Logistic回归分析T2DM患者合并IS的影响因素,并用Pearson相关性分析FBG与其它指标的关系。结果:T2DM组与T2DM+IS组BMI、收缩压(SBP)、舒张压(DBP)、甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白-胆固醇(LDL-C)、糖化血红蛋白(HbA1c)、FINS、FBG、Hcy及HOMA-IR的水平较对照组均明显升高,高密度脂蛋白-胆固醇(HDL-C)的水平较对照组明显下降(P<0.05)。T2DM+IS组SBP、DBP、LDL-C、HbA1c、FINS、FBG、Hcy及HOMA-IR的水平较T2DM组均明显升高(P<0.05)。多因素Logistic回归分析显示,FINS、FBG、Hcy及HOMA-IR是T2DM患者发生IS的影响因素(P<0.05)。经Pearson相关性分析显示,FBG与HbA1c、FINS、Hcy及HOMA-IR均具有正相关关系(P<0.01)。结论:T2DM患者FBG水平与IS的发生存在显著关系。

Objective: To analyze the effects of fasting blood glucose(FBG), fasting insulin(FINS),homeostatic model assessment for insulin resistance index(HOMA-IR) and homocysteine(Hcy) on type 2 diabetes mellitus(T2DM) complicated with ischemic stroke(IS). Methods: We selected 85 patients with T2DM and divided them into the T2DM + IS group(44 cases) and T2DM group(41 cases) according to whether the patient experienced IS. During the same period, 30 healthy volunteers were selected as the control group. The differences in body mass index(BMI), blood pressure, blood glucose, and four indexes of blood lipid among the three groups were compared, and the HOMA-IR was calculated. Multivariate logistic regression was used to analyze the influencing factors of T2DM complicated with IS, and Pearson correlation analysis was used to analyze the relationship between FBG and other indicators. Results: The levels of BMI, systolic blood pressure(SBP), diastolic blood pressure(DBP), triglyceride(TG), total cholesterol(TC),low-density lipoprotein-cholesterol(LDL-C), hemoglobin A1c(HbA1c), FINS, FBG, Hcy, and HOMA-IR in the T2DM group and T2DM+IS group were significantly higher than those in control group, and the level of high density lipoprotein cholesterol(HDL-C) was significantly lower than that in the control group(P<0.05).The levels of SBP, DBP, LDL-C, HbA1c, FINS, FBG, Hcy, and HOMA-IR in the T2DM + IS group were significantly higher than those in the T2DM group(P<0.05). Multivariate logistic regression analysis showed that FINS, FBG, Hcy, and HOMA-IR were the influencing factors of IS in patients with T2DM(P<0.05).Pearson correlation analysis showed that FBG was positively correlated with HbA1c, FINS, Hcy, and HOMA-IR(P<0.01). Conclusion: There is a significant relationship between FBG level and the occurrence of IS in patients with T2DM.