糖耐量减低患者胰岛素抵抗与颈动脉粥样斑块的相关性分析

INSULIN RESISTANCE AND CAROTID ATHEROSCLEROSIS IN IMPAIRED GLUCOSE TOLERANCE

目的 探讨胰岛素抵抗 (IR)在糖耐量减低 (IGT)大血管并发症中的作用。方法 测定 1 2 0名IGT患者和 96名糖耐量正常(NGT)对照者的空腹血糖 (FBG)、胆固醇 (TC)、甘油三酯 (TG)、胰岛素 (FINS)及餐后 2h血糖 (PBG) ,并测量身高、体重、腰围、臀围 ,计算相对胰岛素敏感指数 (RISI)、体重指数 (BMI)、腰臀比 (WHR) ,结合其颈动脉多普勒超声检测结果进行对比分析。结果 IGT组及NGT组颈动脉粥样斑块发生率有显著性差异 (P <0 .0 0 1 ) ,斑块面积与RISI呈负相关 (r =- 0 .45 ,P <0 .0 1 ) ,与餐后 2h血糖 (r =0 .39,P <0 .0 1 )、BMI(r=0 .48,P <0 .0 1 )及WHR(r=0 .41 ,P <0 .0 1 )正相关 ,而与TG、FBG、TC、FINS无相关性 (P >0 .0 5)。IGT组患者有斑块和无斑块者之间RISI、WHR、BMI、餐后 2h血糖、TG之间也存在显著性差异 (P <0 .0 1 )。结论 胰岛素抵抗与颈动脉粥样硬化的发生密切相关 ,是IGT患者发生大血管并发症的重要原因。

Objective To evaluate the effect of insulin resistance(IR) on the macrovascular complications of impaired glucose tolerance(IGT). Methods The idexes were examined by carotid ultrasonographic in 120 cases of IGT and 96 cases of normal glucose tolerance(NGT) as follows, fasting and postprandial plasma glucose(FPG and PBG),fasting insulin (FINS),total cholesterol,triglyceride(TC and TG), body mass index(BMI) and waist/hip ratio(WHR). Results 48 cases with carotid artery plaque were found in IGT and 5 cases in NGT(P<0.001),the plaque area had positive correlation with PBG(r= 0.39 ,P<0.01), BMI (r=0.48,P<0.01),WHR (r=0.41,P<0.01) and inverse correlation with relative insulin sensitivity index(RISI)(r=-0.45,P<0.01),but no correlation were found with TG and TC. There were significant differences between with and without carotid artery plaque groups in IGT on RISI,WHR,BMI,TG and PBG (P<0.01). Conclusion There is a close relationship between IR and carotid artery atherosclerosis and IR is a major cause for the macrovascular complications in IGT.