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目的了解糖调节受损(IGR)患者的空腹胰岛素(FINS)水平与发生亚临床大血管病变之间的相关性,为研究IGR患者发生亚临床大血管病变的危险因素提供依据。方法将115例IGR患者根据颈动脉彩超结果,分为亚临床大血管病变组(n=57)和无病变组(n=58),进行既往史、个人史调查,测量体重、身高、臀围和腰围,测定空腹及餐后2h血糖、空腹胰岛素(FINS)、血脂、丙氨酸转氨酶(ALT)和肾功能,并计算稳态模型胰岛素抵抗指数(HOMA-IR)。结果亚临床大血管病变组年龄([64.8±7.8)岁]高于无血管病变组([55.0±8.6)岁],差异有统计学意义(P<0.01)。与无血管病变组比较,亚临床大血管病变组高血压检出率(70.2%)明显升高,高血压病程([5.64±7.08)年]明显延长,SBP([141.88±16.96)mmHg]、UA([368.00±74.20)μmol/L]明显升高,FINS([6.43±3.51)mIU/L]、HOMA-IR(1.76±1.07)明显降低,差异均有统计学意义(P<0.01,P<0.05)。两组体质指数(BMI)、腰臀比(WHR)、舒张压(DBP)、血脂、尿素氮(BUN)、血肌酐(Cr)差异均无统计学意义(P>0.05)。多因素非条件logistic回归分析显示,FINS(OR=0.10,95%CI:0.01～0.91,P=0.040)和年龄(OR=1.21,95%CI:1.08～1.36,P=0.001)是IGR患者亚临床大血管病变的影响因素。结论低水平的FINS可能是IGR患者发生亚临床大血管病变的危险因素。
Objective To investigate the relationship between fasting insulin (FINS) levels and occurrence of subclinical macrovascular complications in patients with impaired glucose regulation (IGR), and to provide evidence for studying the risk factors of subclinical macrovascular complications in patients with IGR. Methods One hundred and fifteen patients with IGR were divided into subclinical macrovascular disease group (n = 57) and non-diseased group (n = 58) according to the results of carotid ultrasonography. The past and history of IGR patients were surveyed. Body weight, height, Fasting and postprandial 2-hour blood glucose, fasting insulin (FINS), serum lipids, alanine aminotransferase (ALT) and renal function were measured. The homeostasis model insulin resistance index (HOMA-IR) was calculated. Results The age of subclinical macroangiopathy group (64.8 ± 7.8) years old was higher than that of no vascular disease group (55.0 ± 8.6 years), the difference was statistically significant (P0.01). Compared with non-vascular disease group, the detection rate of hypertension (70.2%) in subclinical macrovascular disease group was significantly higher, duration of hypertension (5.64 ± 7.08) was significantly longer, SBP (141.88 ± 16.96) mmHg, UA significantly increased ([368.00 ± 74.20] μmol / L, FINS (6.43 ± 3.51) mIU / L] and HOMA-IR (1.76 ± 1.07), and the difference was statistically significant (P <0.01, P <0.05). BMI, WHR, DBP, BUN and Cr had no significant difference between the two groups (P> 0.05). Multivariate non-conditional logistic regression analysis showed that FINS (OR = 0.10, 95% CI: 0.01-0.91, P = 0.040) and age (OR = 1.21, 95% CI: 1.08-1.36, P = 0.001) Factors influencing clinical macrovascular disease. Conclusions Low-level FINS may be a risk factor for subclinical macroangiopathy in patients with IGR.