摘要
目的探讨高甘油三酯（ＴＧ）血症与胰岛素抵抗（ＩＲ）及糖代谢异常之间的关系。方法将７１例高ＴＧ血症患者按照空腹血ＴＧ增高的程度分为高ＴＧⅠ组和Ⅱ组，做葡萄糖耐量（ＯＧＴＴ）和胰岛素（Ｉｎｓ）释放试验，计算胰岛素敏感性指数（ＩＳＩ），并以３２例正常血ＴＧ者作对照。采用多因素回归分析ＴＧ与ＩＳＩ之间的相关性。对４５例高ＴＧ者作治疗前后的动态观察。结果高ＴＧⅠ组血糖高峰出现在服糖后３０分钟，与正常ＴＧ组时相一致，但高于后者（Ｐ＜００１），Ｉｎｓ高峰出现在服糖后６０分钟，与高ＴＧⅡ组时相一致，但低于高ＴＧⅡ组（Ｐ＜００５）；空腹血糖和Ｉｎｓ水平在高ＴＧⅠ组高于正常ＴＧ组，但低于高ＴＧⅡ组（Ｐ＜００１～０００１）；服糖后１８０分钟，高ＴＧⅡ组血糖和Ｉｎｓ水平高于高ＴＧⅠ组和正常ＴＧ组（Ｐ＜００５～０００１），高ＴＧⅠ组血糖与正常ＴＧ组无显著差异（Ｐ＞００５），但Ｉｎｓ水平高于正常ＴＧ组（Ｐ＜０００１）。正常ＴＧ组、高ＴＧⅠ组和Ⅱ组糖代谢异常总发生率分别为６２％、１９２％和２５０％。高ＴＧⅠ组ＩＳＩ低于正常ＴＧ组，但高于高ＴＧⅡ组（Ｐ＜００１～０００１）。多因素回归分析结果表明ＴＧ是影响ＩＳＩ的?
Objective To explore the correlation of hypertriglyceridemia (HTG) with insulin resistance (IR) and abnormal glucose metabolism. Methods 71 patients with HTG were divided into HTG group Ⅰ and group Ⅱ according to the level of fasting blood triglyceride (TG). Oral glucose tolerance test (OGTT) and insulin release test were performed and insulin sensitivity index (ISI) was calculated. The results were compared with those in 32 controls with normal blood TG level. Multi factor regression analysis was adopted to reveal the correlations between TG and ISI. Dynamic observation was also made for 45 cases with high TG level before and after treatment. Results In HTG group Ⅰ, the peak of blood glucose appeared 30 minutes after glucose intake, being the same as in the normal TG group, but with a higher level ( P <0.01), while the peak of insulin appeared 60 minutes after glucose intake, being the same as in HTG group Ⅱ, but with a lower level ( P <0.05). The fasting blood glucose and insulin level of the patients in HTG group Ⅰ was higher than that in the normal control group but lower than that in HTG group Ⅱ ( P <0.01～0.001). 180 minutes after administration of glucose the level of blood glucose and insulin of the patients in HTG group Ⅱ is higher than that in both the HTG group Ⅰ and the normal control group ( P <0.05～0.001), there was no significant difference in blood glucose between HTG group Ⅰ and the normal control group ( P >0.05), but the insulin level of the patients in HTG group Ⅰ was higher than that in the normal control group ( P <0.001). The total occurrence rate of abnormal glucose metabolism was 6 2%, 19 2% and 25.0% in the normal control group, HTG group Ⅰ and HTG group Ⅱ respectively. In HTG group Ⅰ, the ISI level was lower than that in the normal control group but higher than that in HTG group Ⅱ ( P <0.01～0 001). The results of multi factor regression analysis showed that TG is an independent correlative factor influencing ISI. After the treatment to lower the blood TG level, the fasting blood glucose, insulin and body mass index levels of 45 patients were reduced by 5.73%, 2.24% and 2.08% respectively, while ISI increased by 8.11%. Conclusion HTG is closely related to IR and abnormal glucose metabolism and active treatment of HTG is of important clinical significance for the prevention of abnormal glucose metabolism.
出处
《中华内科杂志》
CAS
CSCD
北大核心
1998年第7期447-450,共4页
Chinese Journal of Internal Medicine
关键词
高甘油三酯血症
糖尿病
胰岛素抵抗
Hypertriglyceridemia Diabetes mellitus Insulin resistance
