胰岛素抵抗对糖尿病患者心功能的影响

Analysis of the effects of insulin resistance on the heart of diabetic patients

目的:探究分析胰岛素抵抗对糖尿病患者心功能的影响。方法:选择2015年1月至2018年3月在我院内分泌科就诊的156例2型糖尿病患者进行回顾性分析,根据患者胰岛素抵抗指数将所有患者分为胰岛素抵抗组(胰岛素抵抗指数≥2.69,n=82),非胰岛素抵抗组(胰岛素抵抗指数<2.69,n=74),并选取同时期在我院体检的和78名健康体检者进行对照观察,对糖尿病控制的各项指标和心功能指标进行检测,进行对比分析。结果:与健康组对比,2型糖尿病患者的FPG、2h PG、HbA1c水平均较高,胰岛素抵抗组患者的FPG、2h PG、HbA1c水平均明显高于非胰岛素抵抗组患者(P<0.05)。与健康组比较,2型糖尿病患者的LVPWTd和WSTd水平较高,且胰岛素抵抗组患者的水平高于非胰岛素抵抗组;LVSV、EF和E/A水平较健康组较低,且胰岛素抵抗组患者的水平低于非胰岛素抵抗组(P<0.05)。Spearman相关性分析显示,胰岛素抵抗与LVEF呈负相关(r=-0.751,P<0.05),与E/A也呈负相关(r=-0.732,P<0.05)。患者胰岛素抵抗是LVEF和E/A受影响的危险因素。结论:2型糖尿病患者心脏的收缩和舒张功能会随着胰岛素抵抗的加重而降低,且胰岛素抵抗是患者左室射血分数和E/A的危险因素,2型糖尿病患者注意并及时对胰岛素抵抗进行针对治疗,可以有效地保护心脏功能。

Objective:To explore the effects of insulin resistance on the heart of diabetic patients.Methods:A total of 156 patients with type 2 diabetes who were treated in Endocrinology Department of our hospital from January 2015 to March 2018 were retrospectively analyzed.According to the insulin resistance index,all patients were divided into insulin resistance group(insulin resistance index≥2.69,n=82)and non insulin resistance group(insulin resistance index<2.69,n=74),and 78 healthy people were selected for control observation.The indexes of diabetes control and cardiac function were detected and compared.Results:Compared with the healthy group,the FPG,2hPG and HbA1c levels of patients with type 2 diabetes were higher,and the FPG,2hPG and HbA1c levels of patients with insulin resistance were significantly higher than those of patients with non insulin resistance(P<0.05).Compared with the healthy group,the lvpwtd and wstd levels of type 2 diabetes patients were higher,and the level of insulin resistance group was higher than that of non insulin resistance group.The levels of LVSV,EF and E/A were lower than those of healthy group,and the level of insulin resistance group was lower than that of non insulin resistance group.The differences were statistically significant(P<0.05).Spearman correlation analysis showed that insulin resistance was negatively correlated with LVEF(r=-0.751,P<0.05)and E/A(r=-0.732,P<0.05).Insulin resistance is a risk factor for LVEF and E/A.Conclusion:The contraction and diastolic function of the heart in type 2 diabetic patient decreases with the increase of insulin resistance,and insulin resistance is a risk factor for left ventricular ejection fraction and E/A.Patients with type 2 diabetes pay attention to and promptly respond to insulin resistance.Treatment can effectively protect heart function.