中国综合临床
中國綜閤臨床
중국종합림상
CLINICAL MEDICINE OF CHINA
2013年
5期
488-491
,共4页
张旭%孙振学%吕豪%王京
張旭%孫振學%呂豪%王京
장욱%손진학%려호%왕경
2型糖尿病%动脉粥样硬化%胰岛素抵抗%超敏C反应蛋白%肿瘤坏死因子α
2型糖尿病%動脈粥樣硬化%胰島素牴抗%超敏C反應蛋白%腫瘤壞死因子α
2형당뇨병%동맥죽양경화%이도소저항%초민C반응단백%종류배사인자α
Type 2 diabetes mellitus%Atherosclerosis%Insulin resistance%Hypersensitive Creactive protein%Tumor necrosis factor-alpha
目的 探讨炎症因子与2型糖尿病患者颈动脉内膜中层厚度(IMT)的关系.方法 50例2型糖尿病患者,根据胰岛素抵抗指数分为胰岛素抵抗组(IR组)26例及非胰岛素抵抗组(NIR组)24例,同时选取24名健康体检者为对照组.3组患者均行超声检查颈动脉IMT,测定空腹血糖(FPG)、空腹胰岛素(FINS)、血脂、超敏C反应蛋白(hs-CRP)及肿瘤坏死因子(TNF-α)等指标,采用自我平衡模型分析法(HOMA)计算胰岛素抵抗指数(HOMA-IR).结果 对照组、NIR组及IR组患者的HOMA-IR、hs-CRP、TNF-α及IMT水平均逐渐增加,且3组间比较差异均有统计学意义[HOMA-IR:1.74±0.49、2.24±0.41、4.89±0.84(F=190.228,P＜0.01);hs-CRP:(1.75±0.83)、(3.08±1.04)、(5.89±1.17) mg/L(F=106.523,P＜0.01);TNF-α:(15.25±7.64)、(23.38±8.82)、(47.42±9.97) rng/L,(F=89.210,P＜0.01)；IMT:(0.69 ±0.31)、(1.07 ±0.32)、(1.49±0.43) mm(F=30.942,P＜0.01)]；相关性分析显示hs-CRP水平与HOMA-IR、IMT水平呈正相关(r值分别为0.453、0.395,P均＜0.05),TNF-α水平与HOMA-IR、IMT水平呈正相关(r值分别为0.428、0.376,P均＜0.05),HOMA-IR水平与IMT水平呈正相关(r =0.403,P＜0.05).结论 2型糖尿病患者存在炎症反应,并与胰岛素抵抗密切相关,炎症因子与胰岛素抵抗在2型糖尿病患者颈动脉粥样硬化的发生、发展过程中起着重要的作用.
目的 探討炎癥因子與2型糖尿病患者頸動脈內膜中層厚度(IMT)的關繫.方法 50例2型糖尿病患者,根據胰島素牴抗指數分為胰島素牴抗組(IR組)26例及非胰島素牴抗組(NIR組)24例,同時選取24名健康體檢者為對照組.3組患者均行超聲檢查頸動脈IMT,測定空腹血糖(FPG)、空腹胰島素(FINS)、血脂、超敏C反應蛋白(hs-CRP)及腫瘤壞死因子(TNF-α)等指標,採用自我平衡模型分析法(HOMA)計算胰島素牴抗指數(HOMA-IR).結果 對照組、NIR組及IR組患者的HOMA-IR、hs-CRP、TNF-α及IMT水平均逐漸增加,且3組間比較差異均有統計學意義[HOMA-IR:1.74±0.49、2.24±0.41、4.89±0.84(F=190.228,P＜0.01);hs-CRP:(1.75±0.83)、(3.08±1.04)、(5.89±1.17) mg/L(F=106.523,P＜0.01);TNF-α:(15.25±7.64)、(23.38±8.82)、(47.42±9.97) rng/L,(F=89.210,P＜0.01)；IMT:(0.69 ±0.31)、(1.07 ±0.32)、(1.49±0.43) mm(F=30.942,P＜0.01)]；相關性分析顯示hs-CRP水平與HOMA-IR、IMT水平呈正相關(r值分彆為0.453、0.395,P均＜0.05),TNF-α水平與HOMA-IR、IMT水平呈正相關(r值分彆為0.428、0.376,P均＜0.05),HOMA-IR水平與IMT水平呈正相關(r =0.403,P＜0.05).結論 2型糖尿病患者存在炎癥反應,併與胰島素牴抗密切相關,炎癥因子與胰島素牴抗在2型糖尿病患者頸動脈粥樣硬化的髮生、髮展過程中起著重要的作用.
목적 탐토염증인자여2형당뇨병환자경동맥내막중층후도(IMT)적관계.방법 50례2형당뇨병환자,근거이도소저항지수분위이도소저항조(IR조)26례급비이도소저항조(NIR조)24례,동시선취24명건강체검자위대조조.3조환자균행초성검사경동맥IMT,측정공복혈당(FPG)、공복이도소(FINS)、혈지、초민C반응단백(hs-CRP)급종류배사인자(TNF-α)등지표,채용자아평형모형분석법(HOMA)계산이도소저항지수(HOMA-IR).결과 대조조、NIR조급IR조환자적HOMA-IR、hs-CRP、TNF-α급IMT수평균축점증가,차3조간비교차이균유통계학의의[HOMA-IR:1.74±0.49、2.24±0.41、4.89±0.84(F=190.228,P＜0.01);hs-CRP:(1.75±0.83)、(3.08±1.04)、(5.89±1.17) mg/L(F=106.523,P＜0.01);TNF-α:(15.25±7.64)、(23.38±8.82)、(47.42±9.97) rng/L,(F=89.210,P＜0.01)；IMT:(0.69 ±0.31)、(1.07 ±0.32)、(1.49±0.43) mm(F=30.942,P＜0.01)]；상관성분석현시hs-CRP수평여HOMA-IR、IMT수평정정상관(r치분별위0.453、0.395,P균＜0.05),TNF-α수평여HOMA-IR、IMT수평정정상관(r치분별위0.428、0.376,P균＜0.05),HOMA-IR수평여IMT수평정정상관(r =0.403,P＜0.05).결론 2형당뇨병환자존재염증반응,병여이도소저항밀절상관,염증인자여이도소저항재2형당뇨병환자경동맥죽양경화적발생、발전과정중기착중요적작용.
Objective To explore the relationship between the levels of inflammatory factors and carotid intima-media thickness (IMT) in patients with type 2 diabetes mellitus (T2DM).Methods Fifty patients with T2DM were recruited and divided into T2DM with insulin resistance(IR) group(26 patients) and T2DM without insulin resistance (NIR) group (24 patients) according to insulin resistance index (HOMA-IR).Twenty-four healthy individuals conducting physical examination were recruited as the healthy control group.All participants underwent carotid ultrasound IMT to assess carotid intima-media thickness.The level of fasting plasma glucose (FPG),fasting insulin (FINS),blood lipids,high sensitivity C reactive protein (hs-CRP) and tumor necrosis factor-α(TNF-α) were measured.Homeostasis model assessment (HOMA)index was used for quantitative analysis of HOMA-IR.Results The levels of HOMA-IR,hs-CRP,TNF-α and IMT in control group,NIR group and IR group increased gradually and were significantly different(HOMA-IR:(1.74 ±0.49) vs.(2.24 ±0.41) vs.(4.89 ±0.84) ;F =190.228,P ＜0.01) ;hs-CRP(mg/L):(1.75 ±0.83) vs.(3.08 ± 1.04) vs.(5.89 ± 1.17) ;F =106.523,P ＜ 0.01) ;TNF-α (ng/L):(15.25 ± 7.64) vs.(23.38 ± 8.82) vs.(47.42 ± 9.97) ;F =89.210,P＜0.01) ;IMT(mm):(0.69 ±0.31) vs.(1.07±0.32) vs.(1.49±0.43);F=30.942,P＜0.01).Correlation analysis showed that the level of hs-CRP was positively correlated with the levels of HOMA-IR and IMT (r =0.453 and 0.395 respectively,P ＜ 0.05) ;The level of TNF-α was positively correlated with the levels of HOMA-IR and IMT (r =0.428 and 0.376 respectively,P ＜ 0.05) ; The level of HOMA-IR was positively correlated with the level of IMT (r =0.403,P ＜ 0.05).Conclusion Inflammatory activity is found in patients with T2DM,which is significantly correlated with insulin resistance.Inflammatory factors and insulin resistance play an important role in the occurrence and development of carotid atherosclerosis in patients with T2DM.
