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目的探讨急性冠状动脉综合征(acute coronary syndrome,ACS)患者血清同型半胱氨酸水平与胰岛素抵抗的关系。方法经冠状动脉造影证实的ACS患者224例(ACS组),冠状动脉造影正常者168例为对照组,2组采用循环酶法测定血清同型半胱氨酸水平,并分析其与胰岛素抵抗间关系。结果 ACS组血清同型半胱氨酸、空腹血糖、空腹胰岛素、体质量指数、胰岛素抵抗指数较对照组升高(P<0.05),胰岛素敏感性指数较对照组降低(P<0.05);ACS患者血清同型半胱氨酸水平与空腹胰岛素(r=0.192,P<0.01)、胰岛素抵抗指数(r=0.216,P<0.01)呈正相关,与胰岛素敏感性指数呈负相关(r=-0.147,P<0.05)。结论 ACS患者存在血清同型半胱氨酸水平明显升高及胰岛素抵抗,二者具有相关性。
Objective To investigate the relationship between serum homocysteine and insulin resistance in patients with acute coronary syndrome (ACS). Methods Two hundred and seventy-four ACS patients (ACS group) confirmed by coronary angiography and 168 normal coronary angiography were enrolled in the study. Serum homocysteine level was measured by cyclic enzyme in two groups and their relationship with insulin resistance . Results Serum levels of homocysteine, fasting blood glucose, fasting insulin, body mass index and insulin resistance in ACS group were significantly higher than those in control group (P <0.05), insulin sensitivity index was lower than that in control group (P <0.05) Serum homocysteine level was positively correlated with fasting insulin (r = 0.192, P <0.01), insulin resistance index (r = 0.216, P <0.01) and negatively correlated with insulin sensitivity index <0.05). Conclusions Serum homocysteine levels and insulin resistance are elevated in patients with ACS, both of which are correlated.