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2型糖尿病患者胰岛素抵抗与肺功能的相关性研究 被引量:2

Relationship between Insulin Resistance and Pulmonary Function in Patients with Type 2 Diabetes Mellitus
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摘要 背景近年来糖尿病导致的肺功能损伤开始引起人们的关注,胰岛素抵抗(IR)是2型糖尿病(T2DM)的重要发病机制,但其与肺功能的关系尚未明确。目的分析T2DM患者IR与肺功能的相关性。方法选取2019年8—12月在首都医科大学附属北京朝阳医院综合科及内分泌科住院的260例T2DM患者,根据有无IR分为IR组(n=105)与无IR组(n=155)。比较两组患者一般资料、实验室检查指标及肺功能指标,采用Spearman秩相关分析及多元线性回归分析探讨T2DM患者胰岛素抵抗指数(HOMA-IR)的相关因素。结果IR组患者年龄小于无IR组,体质指数(BMI)大于无IR组,糖化血红蛋白(HbA1c)、空腹血糖(FPG)、三酰甘油(TG)及超敏C反应蛋白(hs-CRP)高于无IR组,高密度脂蛋白(HDL)低于无IR组(P<0.05)。IR组患者用力肺活量占预计值的百分比(FVC%pred)、第1秒用力呼气容积占预计值的百分比(FEV1%pred)、肺总量占预计值的百分比(TLC%pred)低于无IR组(P<0.05)。Spearman秩相关分析结果显示,T2DM患者HOMA-IR与BMI、HbA1c、FPG、TG、hs-CRP呈正相关,与HDL、FVC%pred、FEV1%pred、TLC%pred、肺一氧化碳弥散量占预计值的百分比(DLCO%pred)呈负相关(P<0.05)。多元线性回归分析结果显示,T2DM患者HOMA-IR分别与FVC%pred(β=-0.610)、FEV1%pred(β=-0.506)、TLC%pred(β=-0.511)、DLCO%pred(β=-0.583)独立相关(P<0.05)。结论伴有IR的T2DM患者肺功能损伤主要表现为限制性通气功能及弥散功能下降,且HOMA-IR越高则T2DM患者限制性通气功能及弥散功能下降越明显。 Background In recent years,pulmonary function injury caused by diabetes has attracted people's attention.Insulin resistance(IR)is an important pathogenesis of type 2 diabetes mellitus(T2DM).However,the relationship between IR and pulmonary function has not been clear.Objective To analyze the relationship between IR and pulmonary function in T2DM patients.Methods A total of 260 T2DM patients hospitalized in the Department of General Internal Medicine and Department of Endocrinology,Beijing Chao-yang Hospital,Capital Medical University from August to December in 2019 were selected.All patients were divided into IR group(n=105)and non-IR group(n=155)according to the presence or absence of IR.The general data,laboratory examination indicators and pulmonary function indexes were compared between the two groups.Spearman rank correlation analysis and multiple linear regression analysis were used to explore the related factors of homeostasis model-insulin resistance(HOMA-IR)in T2DM patients.Results The age in the IR group was younger than that in the non-IR group,body mass index(BMI)in the IR group was greater than that in the non-IR group,glycosylated hemoglobin(HbA1c),fasting blood glucose(FPG),triglyceride(TG)and high-sensitivity C-reactive protein(hs-CRP)in the IR group were higher than those in the non-IR group,and high-density lipoprotein(HDL)in the IR group was lower than that in the non-IR group(P<0.05).The percentage of forced vital capacity in predicted value(FVC%pred),percentage of forced expiratory volume in the first second in predicted value(FEV1%pred)and percentage of total lung capacity in predicted value(TLC%pred)in the IR group were lower than those in the non-IR group(P<0.05).Spearman rank correlation analysis showed that HOMA-IR was positively correlated with BMI,HbA1c,FPG,TG and hs-CRP,and negatively correlated with HDL,FVC%pred,FEV1%pred,TLC%pred and percentage of diffusion capacity for carbon monoxide of lung in predicted value(DLCO%pred)in T2DM patients(P<0.05).Multiple linear regression analysis showed that HOMA-IR was independently correlated with FVC%pred(β=-0.610),FEV1%pred(β=-0.506),TLC%pred(β=-0.511),DLCO%pred(β=-0.583)in T2DM patients,respectively(P<0.05).Conclusion Pulmonary function injury in T2DM patients with IR is mainly characterized by the decline of restrictive ventilation function and diffusion function,and the higher HOMA-IR,the more obvious the decline of restrictive ventilation function and diffusion function in T2DM patients.
作者 何云云 陈哲 方向阳 常晶 逯勇 王晓娟 HE Yunyun;CHEN Zhe;FANG Xiangyang;CHANG Jing;LU Yong;WANG Xiaojuan(Department of General Internal Medicine,Beijing Chao-yang Hospital,Capital Medical University,Beijing 100020,China;Department of Endocrinology,Beijing Chao-yang Hospital,Capital Medical University,Beijing 100020,China;Department of Respiratory and Critical Care Medicine,Beijing Chao-yang Hospital,Capital Medical University,Beijing 100020,China)
出处 《实用心脑肺血管病杂志》 2021年第10期81-85,共5页 Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease
基金 北京市属医院科研培育计划项目(PX2018014)。
关键词 2型糖尿病 胰岛素抵抗 肺功能 Type 2 diabetes mellitus Insulin resistance Pulmonary function
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