2型糖尿病及前期患者血脂水平变化及其与胰岛素抵抗的关系

Changes of Blood Lipid Levels in Patients with Type 2 Diabetes Mellitus and Pre-diabetes Mellitus and Their Relationship with Insulin Resistance

目的:探讨2型糖尿病及前期患者血脂水平变化及其与胰岛素抵抗的关系。方法:选取2014年1月—2017年1月我院收治的2型糖尿病患者(DM组)、糖尿病前期患者(PDM组)、体检健康人员(健康组)各100例,检测并比较三组空腹血糖(FPG)、餐后2 h血糖(2hPG)、空腹胰岛素(FINS)、胰岛素抵抗指数(HOMA-IR)、体质量指数(BMI)、腰臀比(WHR)、血脂[三酰甘油(TG)、胆固醇(TC)、高密度脂蛋白(HDL-C)、低密度脂蛋白(LDL-C)]等指标,并分析HOMA-IR与这些指标的关系及血脂水平与胰岛素抵抗的关系。结果:DM组FPG、2hPG、FINS、HOMA-IR、BMI、WHR、TG水平明显高于PDM组,PDM组明显高于健康组,差异有统计学意义(P <0.05);DM组HDL-C水平明显低于PDM组,PDM组明显低于健康组,差异有统计学意义(P <0.05);三组TC、LDL-C水平比较差异无统计学意义(P> 0.05);Pearson相关性分析显示,HOMA-IR与FPG、2hPG、FINS、BMI、WHR、TG呈正相关,与HDL-C呈负相关(P <0.05);Logistics回归分析显示,在校正FPG、2hPG、FINS、BMI、WHR等因素后,高TG和低HDL-C水平是胰岛素抵抗的独立影响因素(P <0.05)。结论:2型糖尿病及前期患者存在脂代谢紊乱状态,并以高TG和低HDL-C为主,血脂水平与胰岛素抵抗密切相关。

Objective:To investigate the changes of blood lipid levels in patients with type 2 diabetes mellitus and pre-diabetes mellitus and their relationship with insulin resistance.Methods:100 patients with type 2 diabetes mellitus(DM group),100 patients with pre-diabetes mellitus(PDM group)and 100 healthy persons(health group)admitted to out hospital from January 2014 to January 2017 were selected.The indexes such as fasting blood glucose(FPG),postprandial 2 h blood glucose(2hPG),fasting insulin(FINS),insulin resistance index(HOMA-IR),body mass index(BMI),waist-to-hip ratio(WHR)and blood lipids[triglyceride(TG),cholesterol(TC),high-density lipoprotein(HDL-C),low-density lipoprotein(LDL-C)]in the three groups were detected and compared,and the relationship of HOMA-IR with these indexes and the relationship of blood lipid levels with insulin resistance were analyzed.Results:The levels of FPG,2hPG,FINS,HOMA-IR,BMI,WHR and TG in the DM group were signi?cantly higher than those in the PDM group,and the levels in the PDM group were signi?cantly higher than those in the healthy group,with statistically signi?cant differences(P<0.05).The level of HDL-C in the DM group was signi?cantly lower than that in the PDM group,and the level in the PDM group was significantly lower than that in the healthy group,with statistically significant differences(P<0.05).There were no statistically signi?cant differences in the levels of TC and LDL-C between the three groups(P>0.05);Pearson correlation analysis showed that HOMA-IR was positively correlated with FPG,2hPG,FINS,BMI,WHR and TG,and negatively correlated with HDL-C(P<0.05).Logistic regression analysis showed that high TG and low HDL-C levels were independent influencing factors of insulin resistance after adjusting the factors such as FPG,2hPG,FINS,BMI and WHR(P<0.05).Conclusion:patients with type 2 diabetes mellitus and and pre-diabetes mellitus have disorders of lipid metabolism,and high TG and low HDL-C are dominant.Blood lipid levels are closely correlated with insulin resistance.