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目的探讨2型糖尿病患者心脑血管并发症与血糖、血压、血脂、胰岛素抵抗的关系。方法将286例2型糖尿病患者按有无合并心脑血管并发症进行分组,观察空腹血糖(FBG)、餐后血糖(PBG)、糖化血红蛋白(HbA1c)、空腹胰岛素(FINS)、餐后胰岛素(PINS)、空腹C肽、餐后C肽及血脂水平,并计算胰岛素抵抗指数(IR)、胰岛素敏感指数(ISI),分析这些参数与心脑血管并发症的关系。结果2型糖尿病合并心脑血管并发症组患者年龄较大、血压较高,体质指数(BMI)、FINS、PINS、空腹及餐后C肽、低密度脂蛋白胆固醇(LDL-C)、载脂蛋白E(ApoE)、IR均显著升高,ISI显著下降,与2型糖尿病无心脑血管并发症组相比,差异有显著性。而FBG、PBG、HbA1c、总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、载脂蛋白A(ApoA)、载脂蛋白B(ApoB)差异则无显著性。结论胰岛素抵抗、血脂异常、血压升高是2型糖尿病合并心脑血管并发症的危险因素,参与心脑血管并发症的发生发展。
Objective To investigate the relationship between cardiovascular and cerebrovascular complications and blood glucose, blood pressure, blood lipid and insulin resistance in type 2 diabetic patients. Methods A total of 286 type 2 diabetic patients were divided into two groups according to their cardiovascular and cerebrovascular complications. The levels of fasting blood glucose (FBG), postprandial blood glucose (PBG), HbA1c, fasting insulin (FINS), postprandial insulin PINS), fasting C-peptide, postprandial C-peptide, and blood lipid levels were calculated. Insulin resistance index (IR) and insulin sensitivity index (ISI) were calculated and the relationship between these parameters and cardiovascular and cerebrovascular complications was analyzed. Results The patients with type 2 diabetes complicated with cardiovascular complications were older, had higher blood pressure, body mass index (BMI), FINS, PINS, fasting and postprandial C-peptide, low density lipoprotein cholesterol (LDL-C) Protein A (ApoE), IR were significantly increased, ISI significantly decreased, with type 2 diabetes without cardiovascular complications, the difference was significant. There was no significant difference in FBG, PBG, HbA1c, TC, TG, HDL-C, ApoA and ApoB Sex. Conclusion Insulin resistance, dyslipidemia and hypertension are risk factors of type 2 diabetes mellitus with cardiovascular and cerebrovascular complications and are involved in the occurrence and development of cardiovascular and cerebrovascular complications.