随着人们生活水平的不断提高,心血管疾病(cardiovascular disease, CVD)目前已经排在全球致死疾病中的首位,对人类健康产生了严重威胁,同时也是当前全世界经济负担最重的疾病。2型糖尿病(type 2 diabetes mellitus, T2DM)是各种CVD的独...随着人们生活水平的不断提高,心血管疾病(cardiovascular disease, CVD)目前已经排在全球致死疾病中的首位,对人类健康产生了严重威胁,同时也是当前全世界经济负担最重的疾病。2型糖尿病(type 2 diabetes mellitus, T2DM)是各种CVD的独立危险因素,包括冠心病,心力衰竭(heart failure, HF),中风,外周动脉疾病(peripheral arterial disease, PAD)等。T2DM患者发生CVD的风险较高,极易致使患者出现微血管病变或者大血管病变,其中冠状动脉病变在血管病变中危害性最大。胰岛素抵抗(insulin resistance, IR)是T2DM和CVD的共同病理生理基础,评估IR状态对CVD的防治大有裨益。目前评估IR的方法种类繁多,葡萄糖钳夹技术(glucose clamp technique, GCT)、胰岛素稳态模型技术(homeostatic model assessment of insulin resistance, HOMA-IR)等传统评价方式以其独特的优势使其在某些方面仍然不可替代,但是这些传统评估方法也存在一定的局限性,比如程序步骤相对繁琐复杂、可重复性差、对受试者依从性要求较高等使其不适用于大规模的、常规的临床评估。近年来涌现出诸多新型评估IR的方法,可以通过简单的常规生化测试计算,其在一定程度上弥补了传统IR评估方法的缺点且评估效能不亚于传统评价指标。本文主要阐述IR及其新型评价指标与CVD相关性研究进展。With the continuous improvement of people’s living standards, cardiovascular disease (CVD) has now ranked as the leading cause of death globally, posing a serious threat to human health and being the most economically burdensome disease worldwide. Type 2 diabetes mellitus (T2DM) is an independent risk factor for various cardiovascular diseases, including coronary heart disease, heart failure, stroke, and peripheral arterial disease. Patients with T2DM have a higher risk of developing cardiovascular diseases and are prone to microvascular and macrovascular complications, with coronary artery disease being the most harmful among vascular complications. Insulin resistance (IR) is the common pathophysiological basis of T2DM and CVD, and assessing IR status is beneficial for the prevention and treatment of CVD. Currently, there are many methods for evaluating IR, including the glucose clamp technique (GCT) and the homeostatic model assessment of insulin resistance (HOMA-IR), which have unique advantages and remain unreplaceable in some aspects, but these traditional assessment methods also have certain limitations, such as relatively complex procedural steps, poor reproducibility, and high requirements for the subjects’ compliance, which make them unsuitable for large-scale, routine clinical assessment. In recent years, many novel methods for evaluating IR have emerged, which can be calculated through simple routine biochemical tests. To some extent, these new IR evaluation methods have made up for the shortcomings of traditional IR evaluation methods and have comparable evaluation efficacy to traditional indicators. This article mainly discusses the research progress of the correlation between IR and its novel evaluation indexes with cardiovascular diseases.展开更多
目的分析达格列净治疗2型糖尿病(T2DM)对患者糖脂水平和胰岛素指标及血清网膜素-1的影响及血清网膜素-1与稳态模型评估-胰岛素抵抗指数(HOMA-IR)的相关性。方法选取2018年11月至2019年10月于长江大学附属仙桃市第一人民医院内分泌科收治...目的分析达格列净治疗2型糖尿病(T2DM)对患者糖脂水平和胰岛素指标及血清网膜素-1的影响及血清网膜素-1与稳态模型评估-胰岛素抵抗指数(HOMA-IR)的相关性。方法选取2018年11月至2019年10月于长江大学附属仙桃市第一人民医院内分泌科收治的46例T2DM患者作为观察组,另选取同期32名健康志愿者作为对照组。采用酶联免疫吸附试验(ELISA)测定两组血清omentin-1水平,比较观察组治疗前与对照组及观察组治疗前后体重指数(BMI)、腰臀比(WHR)、血压、糖脂水平、胰岛素指标及血清omentin-1水平,分析T2DM患者治疗前后omentin-1水平与HOMA-IR的相关性。结果观察组治疗前与对照组BMI、WHR、收缩压(SBP)、舒张压(DBP)、总胆固醇(TC)、三酰甘油(TG)水平比较差异均无统计学意义;观察组治疗前空腹血糖(FBG)、餐后2 h血糖(2 h PG)、糖化血红蛋白(HbA1c)、空腹胰岛素(FINS)水平及HOMA-IR均高于对照组,稳态模型评估-胰岛β细胞功能指数(HOMA-β)、血清omentin-1水平均低于对照组,差异有统计学意义(P<0.05)。治疗后,观察组WHR、BMI、FBG、2 h PG、HbA1c、HOMA-IR水平均低于治疗前,HOMA-β、血清omentin-1水平均高于治疗前,差异有统计学意义(P<0.05)。Pearson直线相关分析结果显示,T2DM患者血清omentin-1水平与HOMA-IR呈负相关(r<0,P<0.05)。结论T2DM患者糖脂、血清omentin-1水平和胰岛β细胞功能异常,血清omentin-1与HOMA-IR呈负相关,达格列净能有效降低T2DM患者糖脂水平,提高血清omentin-1水平,进而可改善胰岛β细胞功能。展开更多
Objective: To determine the prevalence of insulin resistance (IR) in a large p opulation of patients with the polycystic ovary syndrome (PCOS). Design: Prospec tive, case-control. Setting: University medical center. P...Objective: To determine the prevalence of insulin resistance (IR) in a large p opulation of patients with the polycystic ovary syndrome (PCOS). Design: Prospec tive, case-control. Setting: University medical center. Patient(s): Two hundred seventy-one PCOS patients and 260 eumenorrheic, non-hirsute, control women. I ntervention(s): History and physical examination and blood sampling. Main Outcom e Measure(s): Total T, free T, DHEAS, sex hormone-binding globulin, and fasting glucose and insulin levels; homeostatic model assessment values for IR (HOMA-I R) and percent β-cell function (HOMA-%β-cell). Result(s): Patients with PC OS and controls differed significantly in all parameters studied, except fasting glucose. Because the HOMA-IR and HOMA-%β-cell values were variably associa ted with race, age, and body mass index, the HOMA-IR and HOMA-%β-cell value s were then adjusted for these cofounders. After adjustment, 64.4%of PCOS patie nts were noted to be insulin resistant, and 2.6%had β-cell dysfunction. Compa red with PCOS patients without IR (n = 96), patients with IR (n = 174) were more obese and had higher β-cell function. Conclusion(s): In patients with PCOS, t he prevalence of IR was 64%according to the HOMA-IR measurement, after adjustm ent. Patients with IR were more clinically affected. Although IR is a common abn ormality in PCOS, it does not seem to be a universal feature.展开更多
文摘随着人们生活水平的不断提高,心血管疾病(cardiovascular disease, CVD)目前已经排在全球致死疾病中的首位,对人类健康产生了严重威胁,同时也是当前全世界经济负担最重的疾病。2型糖尿病(type 2 diabetes mellitus, T2DM)是各种CVD的独立危险因素,包括冠心病,心力衰竭(heart failure, HF),中风,外周动脉疾病(peripheral arterial disease, PAD)等。T2DM患者发生CVD的风险较高,极易致使患者出现微血管病变或者大血管病变,其中冠状动脉病变在血管病变中危害性最大。胰岛素抵抗(insulin resistance, IR)是T2DM和CVD的共同病理生理基础,评估IR状态对CVD的防治大有裨益。目前评估IR的方法种类繁多,葡萄糖钳夹技术(glucose clamp technique, GCT)、胰岛素稳态模型技术(homeostatic model assessment of insulin resistance, HOMA-IR)等传统评价方式以其独特的优势使其在某些方面仍然不可替代,但是这些传统评估方法也存在一定的局限性,比如程序步骤相对繁琐复杂、可重复性差、对受试者依从性要求较高等使其不适用于大规模的、常规的临床评估。近年来涌现出诸多新型评估IR的方法,可以通过简单的常规生化测试计算,其在一定程度上弥补了传统IR评估方法的缺点且评估效能不亚于传统评价指标。本文主要阐述IR及其新型评价指标与CVD相关性研究进展。With the continuous improvement of people’s living standards, cardiovascular disease (CVD) has now ranked as the leading cause of death globally, posing a serious threat to human health and being the most economically burdensome disease worldwide. Type 2 diabetes mellitus (T2DM) is an independent risk factor for various cardiovascular diseases, including coronary heart disease, heart failure, stroke, and peripheral arterial disease. Patients with T2DM have a higher risk of developing cardiovascular diseases and are prone to microvascular and macrovascular complications, with coronary artery disease being the most harmful among vascular complications. Insulin resistance (IR) is the common pathophysiological basis of T2DM and CVD, and assessing IR status is beneficial for the prevention and treatment of CVD. Currently, there are many methods for evaluating IR, including the glucose clamp technique (GCT) and the homeostatic model assessment of insulin resistance (HOMA-IR), which have unique advantages and remain unreplaceable in some aspects, but these traditional assessment methods also have certain limitations, such as relatively complex procedural steps, poor reproducibility, and high requirements for the subjects’ compliance, which make them unsuitable for large-scale, routine clinical assessment. In recent years, many novel methods for evaluating IR have emerged, which can be calculated through simple routine biochemical tests. To some extent, these new IR evaluation methods have made up for the shortcomings of traditional IR evaluation methods and have comparable evaluation efficacy to traditional indicators. This article mainly discusses the research progress of the correlation between IR and its novel evaluation indexes with cardiovascular diseases.
文摘目的分析达格列净治疗2型糖尿病(T2DM)对患者糖脂水平和胰岛素指标及血清网膜素-1的影响及血清网膜素-1与稳态模型评估-胰岛素抵抗指数(HOMA-IR)的相关性。方法选取2018年11月至2019年10月于长江大学附属仙桃市第一人民医院内分泌科收治的46例T2DM患者作为观察组,另选取同期32名健康志愿者作为对照组。采用酶联免疫吸附试验(ELISA)测定两组血清omentin-1水平,比较观察组治疗前与对照组及观察组治疗前后体重指数(BMI)、腰臀比(WHR)、血压、糖脂水平、胰岛素指标及血清omentin-1水平,分析T2DM患者治疗前后omentin-1水平与HOMA-IR的相关性。结果观察组治疗前与对照组BMI、WHR、收缩压(SBP)、舒张压(DBP)、总胆固醇(TC)、三酰甘油(TG)水平比较差异均无统计学意义;观察组治疗前空腹血糖(FBG)、餐后2 h血糖(2 h PG)、糖化血红蛋白(HbA1c)、空腹胰岛素(FINS)水平及HOMA-IR均高于对照组,稳态模型评估-胰岛β细胞功能指数(HOMA-β)、血清omentin-1水平均低于对照组,差异有统计学意义(P<0.05)。治疗后,观察组WHR、BMI、FBG、2 h PG、HbA1c、HOMA-IR水平均低于治疗前,HOMA-β、血清omentin-1水平均高于治疗前,差异有统计学意义(P<0.05)。Pearson直线相关分析结果显示,T2DM患者血清omentin-1水平与HOMA-IR呈负相关(r<0,P<0.05)。结论T2DM患者糖脂、血清omentin-1水平和胰岛β细胞功能异常,血清omentin-1与HOMA-IR呈负相关,达格列净能有效降低T2DM患者糖脂水平,提高血清omentin-1水平,进而可改善胰岛β细胞功能。
文摘Objective: To determine the prevalence of insulin resistance (IR) in a large p opulation of patients with the polycystic ovary syndrome (PCOS). Design: Prospec tive, case-control. Setting: University medical center. Patient(s): Two hundred seventy-one PCOS patients and 260 eumenorrheic, non-hirsute, control women. I ntervention(s): History and physical examination and blood sampling. Main Outcom e Measure(s): Total T, free T, DHEAS, sex hormone-binding globulin, and fasting glucose and insulin levels; homeostatic model assessment values for IR (HOMA-I R) and percent β-cell function (HOMA-%β-cell). Result(s): Patients with PC OS and controls differed significantly in all parameters studied, except fasting glucose. Because the HOMA-IR and HOMA-%β-cell values were variably associa ted with race, age, and body mass index, the HOMA-IR and HOMA-%β-cell value s were then adjusted for these cofounders. After adjustment, 64.4%of PCOS patie nts were noted to be insulin resistant, and 2.6%had β-cell dysfunction. Compa red with PCOS patients without IR (n = 96), patients with IR (n = 174) were more obese and had higher β-cell function. Conclusion(s): In patients with PCOS, t he prevalence of IR was 64%according to the HOMA-IR measurement, after adjustm ent. Patients with IR were more clinically affected. Although IR is a common abn ormality in PCOS, it does not seem to be a universal feature.
