2型糖尿病患者下肢血管功能与胰岛素抵抗的关系

Relationship between vascular function of legs and insulin resistance in patients wih type 2 diabetes mellitus

目的 研究 2型糖尿病患者下肢血管功能与胰岛素抵抗的关系 方法 80例 (男 4 8例 ,女 32例 )无明显下肢缺血和水肿 ,皮色正常 ,足背动脉搏动存在的 2型糖尿病患者纳入研究。血管功能测定采用肢体阻抗血流图仪。胰岛素敏感指数 (ISI) =1 / FPG× FIns。胰岛素抵抗指数 (H- IR) =FPG× FIns/ 2 2 .5。观察踝趾段和膝踝段血管功能与 ISI、H- IR的相关性。 结果 (1 )血管弹性随着ISI减低和 H- IR增高而从正常变差劣。 (2 )随着 ISI下降和 H- IR增加 ,血管阻力逐渐增加。 (3)下肢血流量与 ISI和 H- IR有关 ,ISI降低和 H- IR增加导致下肢血流量降低。 结论 在无明显的下肢缺血的临床迹象的 2型糖尿病患者中 ,下肢血管功能和胰岛素抵抗有密切的关系。胰岛素抵抗的增大可能是

Objective To study the relationship between vascular function of legs and insulin resistance in patients with type 2 diabetes mellitus. Methods 80 diabetic patients (M 48, F 32) without apparent manifestations of ischemia and edema of legs, with normal colour of skin, and normal pulsation of dosalis pedis arteria were studied. Vascular function was determined by a limb impendance blood flow gragh apparatus. Insulin sensitivity index (ISI)=1/FPG×FIns. Insulin resistance index=HOMA IR=FPG×FIns/22.5. The relationship of vascular function of ankle tose and knee ankle segments with ISI, H IR in all of patients was observed. Results The results were as follows: 1. Vascular elasticity became worse than normal along with the decrement of ISI and the increment of H IR. 2. Vascular resistance increased gradually while lowering ISI and increasing H IR. 3. Volume of blood flow in legs was associated with ISI and H IR, and the decrement of ISI and increment of H IR led to the decrement of volume of blood flow in legs. Conclusion There is a close relationship between vascular function of legs and insulin resistance in patients with type 2 diabetes without clinically apparent evidence of ischemia of legs. Increment of insulin resistance might be an independent risk factor in the early stage of peripheral vasculr disease in type 2 diabetes mellitus.