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目的 探讨2型糖尿病(2型DM)患者肥胖与胰岛素抵抗(IR)及脂代谢紊乱之间的关系,以期指导合理用药。方法 根据体重指数(BMI),将260例DM患者分成3组,观察与胰岛素作用指数(IAI)及血脂异常之间的关系。结果 BMI正常组IAI及血脂在正常范围,而超重和肥胖组IAI下降,TG和CH增高,HDL下降。BMI越高,后者改变越明显。结论 肥胖与IR及脂代谢紊乱密切相关。提示肥胖型2型DM的药物治疗应以胰岛素增敏剂、α糖苷酶抑制剂和双胍类为主,同时注重降脂治疗,避免早期使用磺脲类药物。
Objective To investigate the relationship between obesity and insulin resistance (IR) and disorders of lipid metabolism in type 2 diabetes mellitus (type 2 DM) in order to guide the rational use of drugs. Methods According to body mass index (BMI), 260 patients with DM were divided into 3 groups and observed the relationship between insulin action index (IAI) and dyslipidemia. Results In the normal BMI group, the IAI and blood lipids were in the normal range, while the IAI in overweight and obesity groups were decreased, TG and CH were increased, and HDL was decreased. The higher the BMI, the more obvious the latter changes. Conclusion Obesity is closely related to the disorder of IR and lipid metabolism. Tip Obesity type 2 DM drug therapy should be insulin sensitizers, α-glucosidase inhibitors and biguanides mainly focused on lipid-lowering treatment, to avoid the early use of sulfonylureas.