心力衰竭的心功能与胰岛素抵抗及胰岛生长因子-1的相关性

Correlation study among heart function and insulin resistance, insulin growth factor-1 in patients with congestive heart failure

目的:研究充血性心力衰竭(CHF)心功能与胰岛素抵抗(IR)、胰岛素生长因子-1(IGF-1)的相互关系及临床意义。方法:采用放免法对69例CHF患者和30例正常人餐后和空腹胰岛素(FINS)、IGF-1进行测定,对心功能与胰岛素敏感性指数(ISI)及IGF-1的关系进行分析。结果:CHF组的空腹及餐后胰岛素水平均显著高于对照组(P<0.05～<0.01);CHF各组的ISI均低于对照组(P<0.01);IGF-1水平在对照组,心功能Ⅰ、Ⅱ和Ⅳ级组呈进行性减少,分别为26.8±14.6ng/ml、18.5±12.8ng/ml、16.7±11.3ng/ml及11.6±8.2ng/ml(P<0.05～<0.01)。结论:随着心功能的恶化,ISI、IGF-1水平进行性下降,故它们可能参与 CHF的发生和发展过程。

Objective: To explore the relationship among heart function and insulin resistance (IR), plasma IGF-1 in patients with congestive heart failure (CHF). Methods :The levels of fasting and postprandial plasma insulin,and IGF-1 were determined by means of radioimmunoassay in 69 patients with CHF and 30 normal healthy controls. Insulin sensitivity index (ISI) was assessed by reverting fasting plasma glucose and insulin product. All parameters in CHF and normal control group were compared. Results: Compared to normal control group, patients with CHF had significantly higher levels of fasting and postprandial plasma insulin (P<0. 05 - <0. 01) and had lower ISI (P< 0. 01). Level of plasma IGF-1 in control group, patients with NYHA class Ⅱ ,Ⅲand Ⅳ group was 26. 8±14. 6, 18. 5 ±12. 8.16. 7±11. 3 and 11. 6± 8. 2ng/ml respectively (P<0. 05-<0. 01). Conclusion:ISI (IR) and IGF-1 are related with heart function in CHF patients. They may play an important role in the pathogenesis of CHF.