摘要
目的 探讨 2型糖尿病胆囊结石与游离脂肪酸 ,胰岛素抵抗的关系。方法 采用病例对照研究的方法 ,观察 2型糖尿病伴胆囊结石组 (DG)及不伴胆囊结石组 (NDG)各 40例。检测两组对象的体重指数、腰臀比、血脂、血糖、胰岛素 (空腹和餐后 2h)、空腹游离脂肪酸 ,计算出胰岛素抵抗指数、β细胞功能、胰岛素敏感指数等。 结果 DG与NDG组比较 ,年龄 (Age)、体重指数 (BMI)、腰臀比 (WHR)、甘油三酯 (TG)、低密度脂蛋白 (LDL c)、β细胞功能 (HOMA β)、空腹血糖(FBG)差异无统计学意义 (P >0 .0 5 )。DG组胆固醇 (TC)、胰岛素抵抗指数 (IR)、空腹胰岛素 (FIns)及餐后 2h血糖(2hBG)、餐后 2h胰岛素 (2hIns)、空腹游离脂肪酸 (FFA)明显升高 (P <0 .0 5 ) ,高密度脂蛋白 (HDL c)、胰岛素敏感指数(ISI)明显低于NDG组 (P <0 .0 5 ) ,多元逐步回归分析显示 ,FBG、TG、胆囊结石、FFA是胰岛素抵抗的危险因素。结论 2型糖尿病伴胆囊结石比不伴胆囊结石具有更明显的脂代谢紊乱及胰岛素抵抗 ,说明胆囊结石存在部分脂代谢紊乱及胰岛素抵抗。
Objective To explore the relationship of gallstones,free fatty acids and insulin resistance in type 2 diabetic patients.Methods This is a case control study.40 type 2 diabetic patients with gallstones(DG)and 40 type 2 diabetic patients without gallstones(NDG)were enrolled.Body mass index(BMI),waist to hip ratio(WHR),serum lipids,blood glucose and insulin(fasting and 2 hour postprandial).free fatty acids(FFA)were measured in all subject.insulin resistance index(HOMA-IR),HOMA-β,insulin sensitivity index(ISI)were calculated.Results Age,BMI,WHR,serum triglycerides(TG),low density lipoprotein cholesterol(LDL-c),HOMA-β,fast blood glucose(FBG) did not show significant difference between group DG and group NDG(P>0.05).Serum cholesterol(TC),HOMA-IR,fast insulin(FIns),2h blood glucose(2hBG),2h insulin (2hIns)and FFA of group DG were significantly higher than those of group NDG(P<0.05).High density lipoprotein cholesterol(HDL-c),insulin sensitivity index(ISI)of group DG were significantly lower than those of group NDG(P<0.05).Multiple stepwist regression analysis showed that FBG,TG,gallstones,FFA were independent the risk factors for insulin resistance in type 2 diabetes.Conclusion The disorder of lipid metabolism and degree of insulin resistance were more severe in type 2 diabetic patients with gallstones than those in type 2 diabetic patients without gallstones.This study confirms the gallstones in type 2 diabetic patients are closely associated with disorder of lipid metabolism and insulin resistance.
出处
《四川医学》
CAS
2005年第2期129-131,共3页
Sichuan Medical Journal
