论文部分内容阅读
[目的]探讨老年糖尿病患者脂代谢紊乱与胰岛素敏感性的相关性。[方法]用胰岛素抵抗指数(IRI)和胰岛素敏感指数(ISI)作为评价胰岛素敏感性的指标,将35例老年2型糖尿病患者和20例健康体检者的血脂各指标、体重指数(BMI)和腰臀围比(WHR)与IRI和ISI分别进行相关分析。[结果]研究组空腹血糖(FBG)、空腹血清胰岛素(FINS)和IRI均显著高于对照组,ISI则显著低于对照组,组间比较差异均有统计学意义(P﹤0.05);研究组HDL和apoA1均显著低于对照组,TG则明显高于对照组,组间比较差异均有统计学意义(P﹤0.05);而其余血脂指标与对照组比较差异无统计学意义(P﹤0.05)。直线相关分析显示:研究组的ISI与该组的IRI及TG均呈显著负相关(r=-0.815,r=-0.452),而IRI与该组的BMI、WHR和TG均呈显著正相关(r=0.598,r=0.532,r=0.476);对照组的ISI与该组的IRI及BMI均呈显著负相关(r=-0.867,r=-0.685),IRI与BMI则呈显著正相关(r=0.742);两组ISI和IRI与各组血脂其余指标均无显著相关性。[结论]老年2型糖尿病患者具有明显的高胰岛素血症和胰岛素抵抗,其TG水平与IRI和ISI显著相关,提示胰岛素抵抗是老年2型糖尿病患者血脂代谢紊乱的发病机制之一。
[Objective] To investigate the correlation between lipid metabolism disorder and insulin sensitivity in elderly diabetic patients. [Methods] Using insulin resistance index (IRI) and insulin sensitivity index (ISI) as indices to evaluate insulin sensitivity, 35 elderly patients with type 2 diabetes mellitus and 20 healthy subjects were tested for lipid profile, body mass index (BMI) Waist-hip ratio (WHR) and IRI and ISI were analyzed separately. [Results] The fasting blood glucose (FBG), fasting serum insulin (FINS) and IRI of the study group were significantly higher than those of the control group, while the ISI of the study group was significantly lower than that of the control group (P <0.05) The levels of HDL and apoA1 were significantly lower in the control group than in the control group, TG was significantly higher than that in the control group, the difference was statistically significant (P <0.05); while the other lipids were not significantly different from the control group (P < 0.05). Linear correlation analysis showed that there was a significant negative correlation between the ISI of the study group and IRI and TG (r = -0.815, r = -0.452), while the IRI showed a significant positive correlation with BMI, WHR and TG r = 0.598, r = 0.532, r = 0.476). There was a significant negative correlation between ISI and IRI and BMI in the control group (r = -0.867, r = -0.685) r = 0.742). There was no significant correlation between ISI and IRI in the two groups and the other indexes in each group. [Conclusion] Elderly patients with type 2 diabetes have obvious hyperinsulinemia and insulin resistance. The level of TG is significantly correlated with IRI and ISI, suggesting that insulin resistance is one of the pathogenesis of dyslipidemia in senile type 2 diabetic patients.