目的探讨游离脂肪酸(FFA)、胰岛素抵抗指数与前清蛋白比值(HOMA-IR/PAB)、红细胞分布宽度(RDW)预测急性脑梗死(ACI)患者病情转归的价值。方法选取2019年4月—2021年1月西安市第三医院收治的118例ACI患者,根据30 d病情转归分为不良组(n=...目的探讨游离脂肪酸(FFA)、胰岛素抵抗指数与前清蛋白比值(HOMA-IR/PAB)、红细胞分布宽度(RDW)预测急性脑梗死(ACI)患者病情转归的价值。方法选取2019年4月—2021年1月西安市第三医院收治的118例ACI患者,根据30 d病情转归分为不良组(n=28)、良好组(n=90),比较两组基线资料、治疗前、治疗后7 d FFA、HOMA-IR/PAB、RDW水平,应用Spearman及偏相关性分析治疗前、治疗后7 d FFA、HOMAIR/PAB、RDW与mRS评分关系,采用受试者工作特征曲线(ROC)及ROC下面积(AUC)分析治疗前、治疗后7 d FFA、HOMA-IR/PAB、RDW预测病情转归的价值。结果不良组入院时NIHSS评分与良好组比较,差异有统计学意义(P<0.05);不良组治疗前、治疗后7 d FFA、HOMA-IR/PAB、RDW均高于良好组(P<0.05);治疗前、治疗后7 d FFA、HOMA-IR/PAB、RDW与mRS评分呈正相关(P<0.05);将入院时NIHSS评分控制后,治疗前、治疗后7 d FFA、HOMA-IR/PAB、RDW仍与mRS评分相关(P<0.05);治疗7 d后FFA、HOMA-IR/PAB、RDW及联合预测病情转归不良的AUC依次为0.868、0.867、0.881、0.920,均大于治疗前对应指标的AUC。结论ACI病情不良转归患者FFA、HOMA-IR/PAB、RDW升高,均与病情转归有关,联合检测有望成为预测患者病情转归的标志物,为临床提供准确、客观、量化的参考信息。展开更多
<strong>Background: </strong>Progressive insulin resistance (IR) is an important pathophysiologic mechanism of gestational diabetes mellitus (GDM). Homeostatic model assessment (HOMA) is commonly used as a...<strong>Background: </strong>Progressive insulin resistance (IR) is an important pathophysiologic mechanism of gestational diabetes mellitus (GDM). Homeostatic model assessment (HOMA) is commonly used as a parameter of the severity of insulin resistance. <strong>Aims:</strong> To determine indices of insulin resistance (IR) and <em>β</em>-cell function in gestational diabetes mellitus (GDM). <strong>Methods:</strong> This cross sectional study was conducted from March 2017 to September 2018 at Department of Endocrinology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh. The study was performed with 41 GDM and equal number of pregnant women with normal glucose tolerance (NGT) diagnosed on basis of WHO criterion-2013 during 24 - 40 weeks of gestation. Serum glucose was measured by glucose oxidase method and fasting serum insulin was measured by chemiluminescent immunoassay. Equations of homeostatic model assessment (HOMA) were used to calculate insulin indices like-insulin resistance (HOMA-IR), <em>β</em>-cell function (HOMA-B) and insulin sensitivity (HOMA-%S). Data were analyzed and compared by statistical tests. <strong>Results: </strong>A total of eighty-two (82) subjects [41 women with GDM (age: 28.29 ± 3.79 years, BMI: 27.16 ± 4.13 kg/m2) and 41 women with NGT (age: 26.22 ± 5.13 years, BMI: 25.27 ± 3.01 kg/m2)] were included in this study. It was observed that GDM women were significantly older (p = 0.041) and had significantly higher BMI (p = 0.020) than pregnant women with NGT. The GDM group had significantly higher IR as indicated by higher fasting insulin value [GDM vs. NGT;10.19 (7.71 - 13.34) vs. 6.88 (5.88 - 8.47) μIU/ml, median (IQR);p = 0.001] and HOMA-IR [GDM vs. NGT;2.31 (1.73 - 3.15) vs. 1.42 (1.15 - 1.76), median (IQR);p < 0.001], poor <em>β</em>-cell secretory capacity [GDM vs. NGT;HOMA-B: 112.63 (83.52 - 143.93) vs. 128.60 (108.77 - 157.58), median (IQR);p = 0.04] and low insulin sensitivity [GDM vs. NGT;HOMA-%S: 43.29 (31.77 - 57.98) vs. 70.42 (56.86 - 86.59), median (IQR);p < 0.001]. Conclusions: GDM is associated with both insulin resistance and inadequate insulin secretion.展开更多
Introduction: In recent years, flow mediated dilatation (FMD) has become a popular technique in cardiovascular medicine. HOMA-IR was accepted to determine the insulin sensitivity as a valuable standard. In this study,...Introduction: In recent years, flow mediated dilatation (FMD) has become a popular technique in cardiovascular medicine. HOMA-IR was accepted to determine the insulin sensitivity as a valuable standard. In this study, we evaluated the association between HOMA-IR (homeostasis model assessment of insulin resistance) and vascular endothelial dysfunction, as assessed by endothelium- dependent flow-mediated dilatation (FMD) and nitroglycerin-mediated dilatation (NMD), in type 2 Diabetic (DM) patients. Material and Methods: Eighty four (84) consecutive out-patients were enrolled. HOMA-IR was calculated as fasting insulin (μU/ml) multiplied by fasting plasma glucose (FPG) (mg/dl) and divided by 405. The ultrasound method for measuring FMD and NMD has been used. Out of 84 patients, 42 patients were in control group and 42 patients were in diabetic group, which were further subdivided into two groups based on HOMA-IR > 3.0 and above was considered as Group I and HOMA IR < 3.0 and below was considered as Group II. Fasting Plasma Glucose (mmol/dl) (7.74 ± 2.56, 6.81 ± 1.9, p < 0.001) and Fasting Insulin (μU/dl) (13.26 ± 8.09, 6.65 ± 2.36, p < 0.001) were statistically significant in Group I. The baseline mean FMD in controls and cases (Group I and Group II) was 15.36 ± 9.56, 4.15 ± 2.29, 12.21 ± 6.24 (p < 0.001) respectively. By logistic regression analysis the factors which were effective on FMD percentage change (<5.5%) in Group I were BMI (p < 0.02), plasma Insulin (p < 0.04) and triglycerides (p < 0.02). There was a negative co-relation for FMD, NMD and HOMA-IR. Discussion: We conclude that increased HOMA-IR in hyperglycaemic patients is associated with severe endothelial dysfunction which is the marker of the atherosclerosis. Thus the measurement of endothelial vasomotor function which is a comprehensive analysis of atherosclerotic burden may provide a better predictive value of future cardiovascular events than the analysis of each of the traditional risk factors alone.展开更多
目的 探讨2型糖尿病(T2DM)患者不同时间点C肽与胰岛素比值(C/I)同胰岛素抵抗(IR)的相关性,并建立一种新的胰岛素抵抗模型,探讨其对IR的预测价值。方法 收集2020年1月-2021年7月于新疆医科大学第一附属医院住院治疗的T2DM患者258例,分析T...目的 探讨2型糖尿病(T2DM)患者不同时间点C肽与胰岛素比值(C/I)同胰岛素抵抗(IR)的相关性,并建立一种新的胰岛素抵抗模型,探讨其对IR的预测价值。方法 收集2020年1月-2021年7月于新疆医科大学第一附属医院住院治疗的T2DM患者258例,分析T2DM患者各时间点C/I与IR的相关性;根据体质指数(BMI)将T2DM患者分为体重正常组、超重组、肥胖组,对3组间的0 min C/I、30 min C/I、120 min C/I、胰岛素抵抗指数(HOMA-IR)、胰岛β细胞功能指数(HOMA-β)进行组间比较;建立一种新的胰岛素抵抗模型,研究新建立的胰岛素抵抗模型对IR的预测价值。结果 0 min C/I、30 min C/I、120 min C/I与HOMA-IR、HOMA-β均呈负相关;体重正常组、超重组和肥胖组3组间在0 min C/I、30 min C/I、120 min C/I、HOMA-IR、HOMA-β方面比较差异均有统计学意义。ROC曲线显示,新建立的胰岛素抵抗模型可用来预测IR,当HOMA-IR′为2.419(0 min C/I=0.277)时,对IR的预测价值最好,灵敏度为0.629,特异度为0.734,AUC曲线面积为0.756,95%CI为(0.694~0.818)。结论 T2DM患者的IR程度随着0 min C/I的升高而减轻,新建立的胰岛素抵抗模型可用来筛查IR。展开更多
文摘目的探讨游离脂肪酸(FFA)、胰岛素抵抗指数与前清蛋白比值(HOMA-IR/PAB)、红细胞分布宽度(RDW)预测急性脑梗死(ACI)患者病情转归的价值。方法选取2019年4月—2021年1月西安市第三医院收治的118例ACI患者,根据30 d病情转归分为不良组(n=28)、良好组(n=90),比较两组基线资料、治疗前、治疗后7 d FFA、HOMA-IR/PAB、RDW水平,应用Spearman及偏相关性分析治疗前、治疗后7 d FFA、HOMAIR/PAB、RDW与mRS评分关系,采用受试者工作特征曲线(ROC)及ROC下面积(AUC)分析治疗前、治疗后7 d FFA、HOMA-IR/PAB、RDW预测病情转归的价值。结果不良组入院时NIHSS评分与良好组比较,差异有统计学意义(P<0.05);不良组治疗前、治疗后7 d FFA、HOMA-IR/PAB、RDW均高于良好组(P<0.05);治疗前、治疗后7 d FFA、HOMA-IR/PAB、RDW与mRS评分呈正相关(P<0.05);将入院时NIHSS评分控制后,治疗前、治疗后7 d FFA、HOMA-IR/PAB、RDW仍与mRS评分相关(P<0.05);治疗7 d后FFA、HOMA-IR/PAB、RDW及联合预测病情转归不良的AUC依次为0.868、0.867、0.881、0.920,均大于治疗前对应指标的AUC。结论ACI病情不良转归患者FFA、HOMA-IR/PAB、RDW升高,均与病情转归有关,联合检测有望成为预测患者病情转归的标志物,为临床提供准确、客观、量化的参考信息。
文摘<strong>Background: </strong>Progressive insulin resistance (IR) is an important pathophysiologic mechanism of gestational diabetes mellitus (GDM). Homeostatic model assessment (HOMA) is commonly used as a parameter of the severity of insulin resistance. <strong>Aims:</strong> To determine indices of insulin resistance (IR) and <em>β</em>-cell function in gestational diabetes mellitus (GDM). <strong>Methods:</strong> This cross sectional study was conducted from March 2017 to September 2018 at Department of Endocrinology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh. The study was performed with 41 GDM and equal number of pregnant women with normal glucose tolerance (NGT) diagnosed on basis of WHO criterion-2013 during 24 - 40 weeks of gestation. Serum glucose was measured by glucose oxidase method and fasting serum insulin was measured by chemiluminescent immunoassay. Equations of homeostatic model assessment (HOMA) were used to calculate insulin indices like-insulin resistance (HOMA-IR), <em>β</em>-cell function (HOMA-B) and insulin sensitivity (HOMA-%S). Data were analyzed and compared by statistical tests. <strong>Results: </strong>A total of eighty-two (82) subjects [41 women with GDM (age: 28.29 ± 3.79 years, BMI: 27.16 ± 4.13 kg/m2) and 41 women with NGT (age: 26.22 ± 5.13 years, BMI: 25.27 ± 3.01 kg/m2)] were included in this study. It was observed that GDM women were significantly older (p = 0.041) and had significantly higher BMI (p = 0.020) than pregnant women with NGT. The GDM group had significantly higher IR as indicated by higher fasting insulin value [GDM vs. NGT;10.19 (7.71 - 13.34) vs. 6.88 (5.88 - 8.47) μIU/ml, median (IQR);p = 0.001] and HOMA-IR [GDM vs. NGT;2.31 (1.73 - 3.15) vs. 1.42 (1.15 - 1.76), median (IQR);p < 0.001], poor <em>β</em>-cell secretory capacity [GDM vs. NGT;HOMA-B: 112.63 (83.52 - 143.93) vs. 128.60 (108.77 - 157.58), median (IQR);p = 0.04] and low insulin sensitivity [GDM vs. NGT;HOMA-%S: 43.29 (31.77 - 57.98) vs. 70.42 (56.86 - 86.59), median (IQR);p < 0.001]. Conclusions: GDM is associated with both insulin resistance and inadequate insulin secretion.
文摘Introduction: In recent years, flow mediated dilatation (FMD) has become a popular technique in cardiovascular medicine. HOMA-IR was accepted to determine the insulin sensitivity as a valuable standard. In this study, we evaluated the association between HOMA-IR (homeostasis model assessment of insulin resistance) and vascular endothelial dysfunction, as assessed by endothelium- dependent flow-mediated dilatation (FMD) and nitroglycerin-mediated dilatation (NMD), in type 2 Diabetic (DM) patients. Material and Methods: Eighty four (84) consecutive out-patients were enrolled. HOMA-IR was calculated as fasting insulin (μU/ml) multiplied by fasting plasma glucose (FPG) (mg/dl) and divided by 405. The ultrasound method for measuring FMD and NMD has been used. Out of 84 patients, 42 patients were in control group and 42 patients were in diabetic group, which were further subdivided into two groups based on HOMA-IR > 3.0 and above was considered as Group I and HOMA IR < 3.0 and below was considered as Group II. Fasting Plasma Glucose (mmol/dl) (7.74 ± 2.56, 6.81 ± 1.9, p < 0.001) and Fasting Insulin (μU/dl) (13.26 ± 8.09, 6.65 ± 2.36, p < 0.001) were statistically significant in Group I. The baseline mean FMD in controls and cases (Group I and Group II) was 15.36 ± 9.56, 4.15 ± 2.29, 12.21 ± 6.24 (p < 0.001) respectively. By logistic regression analysis the factors which were effective on FMD percentage change (<5.5%) in Group I were BMI (p < 0.02), plasma Insulin (p < 0.04) and triglycerides (p < 0.02). There was a negative co-relation for FMD, NMD and HOMA-IR. Discussion: We conclude that increased HOMA-IR in hyperglycaemic patients is associated with severe endothelial dysfunction which is the marker of the atherosclerosis. Thus the measurement of endothelial vasomotor function which is a comprehensive analysis of atherosclerotic burden may provide a better predictive value of future cardiovascular events than the analysis of each of the traditional risk factors alone.
文摘目的 探讨2型糖尿病(T2DM)患者不同时间点C肽与胰岛素比值(C/I)同胰岛素抵抗(IR)的相关性,并建立一种新的胰岛素抵抗模型,探讨其对IR的预测价值。方法 收集2020年1月-2021年7月于新疆医科大学第一附属医院住院治疗的T2DM患者258例,分析T2DM患者各时间点C/I与IR的相关性;根据体质指数(BMI)将T2DM患者分为体重正常组、超重组、肥胖组,对3组间的0 min C/I、30 min C/I、120 min C/I、胰岛素抵抗指数(HOMA-IR)、胰岛β细胞功能指数(HOMA-β)进行组间比较;建立一种新的胰岛素抵抗模型,研究新建立的胰岛素抵抗模型对IR的预测价值。结果 0 min C/I、30 min C/I、120 min C/I与HOMA-IR、HOMA-β均呈负相关;体重正常组、超重组和肥胖组3组间在0 min C/I、30 min C/I、120 min C/I、HOMA-IR、HOMA-β方面比较差异均有统计学意义。ROC曲线显示,新建立的胰岛素抵抗模型可用来预测IR,当HOMA-IR′为2.419(0 min C/I=0.277)时,对IR的预测价值最好,灵敏度为0.629,特异度为0.734,AUC曲线面积为0.756,95%CI为(0.694~0.818)。结论 T2DM患者的IR程度随着0 min C/I的升高而减轻,新建立的胰岛素抵抗模型可用来筛查IR。
