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目的探讨2型糖尿病非增殖性视网膜病变(NPDR)患者血脂异常与胰岛素抵抗的关系。方法选取NPDR组96例,糖尿病正常眼底(NDR)对照组96例。进行血脂、血糖、空腹及餐后2h血浆胰岛素(Fins、2hIns)的测定,计算胰岛素抵抗指数(HOMA-IR)、体重指数(BMI)。结果⑴NPDR组甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、HOMA-IR较NDR组明显升高,高密度脂蛋白胆固醇(HDL-C)水平明显降低(P<0.05)。⑵NPDR与TG、HOMA-IR呈正相关,与HDL-L呈负相关(P<0.01或P<0.05)。⑶在校正年龄、性别、BMI、收缩压、舒张压等混杂因素后,HOMA-IR与TG、HDL-L相关性依然存在(r值为0.1784、-0.2018,P<0.05)。结论血脂异常、胰岛素抵抗可促进NPDR的发生发展,应尽早干预。
Objective To investigate the relationship between dyslipidemia and insulin resistance in type 2 diabetic patients with non-proliferative retinopathy (NPDR). Methods 96 cases of NPDR group and 96 cases of diabetic normal fundus (NDR) control group were selected. Blood lipids, blood glucose, fasting and postprandial 2h plasma insulin (Fins, 2hIns) were measured to calculate HOMA-IR and BMI. Results (1) TG, LDL-C and HOMA-IR ofNPDR group were significantly higher than those of NDR group, and the level of HDL-C was significantly decreased (P <0.05). ⑵NPDR was positively correlated with TG and HOMA-IR, but negatively correlated with HDL-L (P <0.01 or P <0.05). (3) There was still a correlation between HOMA-IR and TG, HDL-L (r = 0.1784, -0.2018, P <0.05) after adjusting for age, gender, BMI, systolic blood pressure and diastolic blood pressure. Conclusions Dyslipidemia and insulin resistance can promote the occurrence and development of NPDR, and should be interfered as soon as possible.