CAJ | 학술논문

目的探讨控制高甘油三酯(TG)血症对胰岛素抵抗(IR)和糖代谢的影响.方法将86例高TG血症患者随机分为治疗组(T组)和非治疗组(N组),在饮食控制的同时,T组给予非诺贝特0.3 g/日一次顿服,定期复查血脂,N组仅饮食控制.两组高TG血症者均连续追踪观察5年.结果(1)N组血糖、胰岛素及胰岛素抵抗指数(HOMA-IR)随血TG水平上升而上升,胰岛素敏感指数(ISI)随血TG水平上升而下降(P＜0.05～0.01).(2)T组血糖水平与治疗前无显著变化(P＞0.05),但胰岛素水平、HOMA-IR和ISI分别低于和高于治疗前(P均＜0.05).(3)N组5年期间糖代谢异常患病率为9.52%,发生率为7.14%;T组未发现糖代谢异常新增病例.N组糖代谢异常患病率与T组、正常对照组(C组)相比较,相对危险度(RR)分别为4.19和2.86.(4)血TG水平与HOMA-IR正相关(P＜0.01),与ISI负相关(P＜0.01),多元逐步回归分析结果表明,TG与HOMA-IR独立相关(P＜0.05).结论控制高TG血症能够减轻IR,使糖代谢异常和2型糖尿病的发生率降低.
목적탐토공제고감유삼지(TG)혈증대이도소저항(IR)화당대사적영향.방법장86례고TG혈증환자수궤분위치료조(T조)화비치료조(N조),재음식공제적동시,T조급여비낙패특0.3 g/일일차돈복,정기복사혈지,N조부음식공제.량조고TG혈증자균련속추종관찰5년.결과(1)N조혈당、이도소급이도소저항지수(HOMA-IR)수혈TG수평상승이상승,이도소민감지수(ISI)수혈TG수평상승이하강(P＜0.05～0.01).(2)T조혈당수평여치료전무현저변화(P＞0.05),단이도소수평、HOMA-IR화ISI분별저우화고우치료전(P균＜0.05).(3)N조5년기간당대사이상환병솔위9.52%,발생솔위7.14%;T조미발현당대사이상신증병례.N조당대사이상환병솔여T조、정상대조조(C조)상비교,상대위험도(RR)분별위4.19화2.86.(4)혈TG수평여HOMA-IR정상관(P＜0.01),여ISI부상관(P＜0.01),다원축보회귀분석결과표명,TG여HOMA-IR독립상관(P＜0.05).결론공제고TG혈증능구감경IR,사당대사이상화2형당뇨병적발생솔강저.
Objective To explore the effect of control of hypertriglyceridemia on insulin resistance (IR) and glucose metabolism. Methods 86 patients with hypertriglyceridemia were randomized into the treatment (diet control plus fenofibrate 0.3g/d) group (T group) and non-treatment (only diet control) group (N group), and the blood lipid profile was examined periodically.Follow-up was performed for 5 years. Results 1.In N group the levels of blood glucose, insulin and insulin resistance index (HOMA-IR) raised with the increase of TG level and the insulin sensitivity index(ISI) was lowered with the increase of TG level (P<0.05~0.01).2.T group had no significant change in blood glucose level (P>0.05), lower levels of insulin and HOMA-IR, and higher ISI (all P<0.05) at postreatment vs pretreatment.3.In N group the prevalence of abnormal glucose metabolism during the 5 years was 9.52%, and the occurrence rate was 7.14%, while in T group no new case with abnormal glucose metabolism was found.Compared with that in T group and normal control group (C group), the relative risks (RR) for prevalence of abnormal glucose metabolism in N group were 4.19 and 2.86 respectively. 4. The blood TG level was correlated positively with HOMA-IR (P<0.01) and negatively with ISI (P<0.01), and the multiple stepwise regression analysis showed that TG and HOMA-IR were independently correlated (P<0.05). Conclusion Control of hypertriglyceridemia can lessen IR and the prevalences of abnormal glucose metabolism and type 2 diabetes mellitus.