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目的:观察新诊断2型糖尿病(T2DM)患者血脂比值的特点,并探讨短期胰岛素强化治疗对其影响。方法:入组90例新诊断T2DM患者及58例血糖正常对照者,测定两组的身高、体质量、血糖及血脂谱,计算BMI、TC/HDL-C、TG/HDL-C、log(TG/HDL-C)、LDL-C/HDL-C以及HOMA-B和HOMA-IR。T2DM组予胰岛素泵持续皮下输注胰岛素,血糖达标后维持10~14 d,复查上述指标。结果:与对照组相比,新诊断T2DM组血脂异常主要表现为高TG血症及低HDL-C血症比例较高(P<0.05),与HDL-C相关的各血脂比值明显升高(P<0.01)。短期胰岛素强化治疗后患者的各项血脂比值均较治疗前显著下降,且变化值均与HOMA-IR的变化值呈显著正相关(P<0.05)。结论:短期胰岛素强化治疗可显著降低新诊断T2DM患者中升高的HDL-C相关血脂比值,并与改善胰岛素抵抗密切相关。
Objective: To observe the characteristics of serum lipid ratio in patients newly diagnosed with type 2 diabetes mellitus (T2DM) and to investigate the effect of short-term intensive insulin therapy. Methods: 90 newly diagnosed T2DM patients and 58 normal control subjects were enrolled in this study. The body height, body weight, blood glucose and lipid profile of the two groups were measured and the levels of BMI, TC / HDL-C, TG / HDL- / HDL-C), LDL-C / HDL-C and HOMA-B and HOMA-IR. T2DM insulin pump continuous subcutaneous infusion of insulin, blood glucose levels maintained 10 to 14 days, review the above indicators. Results: Compared with the control group, the newly diagnosed dyslipidemia in T2DM group was mainly characterized by a high proportion of hypertriglyceridemia and low HDL-C (P <0.05) and a significant increase of HDL-C-related lipid ratio P <0.01). The levels of serum lipids in patients with short-term intensive insulin treatment decreased significantly compared with those before treatment, and the changes were positively correlated with the changes of HOMA-IR (P <0.05). CONCLUSIONS: Short-term intensive insulin treatment significantly reduces elevated HDL-C-associated serum lipid levels in newly diagnosed T2DM patients and is associated with improved insulin resistance.