正常体重指数腹型肥胖糖尿病患者与胰岛素抵抗的相关性

摘 要

正常体重指数腹型肥胖糖尿病患者与胰岛素

抵抗的相关性

研究生:阿依努尔.木合它尔 导师:伊力多斯 副教授

摘要

目的：在正常体重指数的2型糖尿病患者中探讨腹型肥胖者各项血脂水平、血压、胰岛素抵抗指数、胰岛β细胞功能指数及其与胰岛素抵抗的关系。方法：2007年9月至2008年9月期间在新疆医科大学第一附属医院内分泌科和干综内二科住院的2型糖尿病（T2DM）患者共1713例，其中体重指数正常的T2DM患者297例，以按照腰围分为腹型肥胖（163例）及非腹型肥胖（134例）两个组。收集所有对象的身高、体重、腰围（WC）、血压（BP）、甘油三酯（TG）、总胆固醇（TC）、低密度脂蛋白（LDL-C）、高密度脂蛋白（HDL-C）、空腹血糖（FPG）、空腹胰岛素水平（Fins）、糖化血红蛋白（HbA1C）等指标；采取t检验比较两个组血脂、血压、HOMA-IR、HOMA-β有无统计学差异；并采用多元直线相关分析腰围与各项血指指标、血压、胰岛素抵抗的相关性。结果：（1）腹型肥胖组TG、TC、LDL-C、SBP、DBP、HOMA-IR均显著高于非腹型肥胖组，差异均有统计学意义（P <0.05）；腹型肥胖组HDL-C显著低于非腹型肥胖组，差异有统计学意义（P <0.05）。经协方差校正BMI后仍有显著差异（P <0.05）；两组HOMA-β差异无统计学意义（P＞0.05）。（2）腰围、BMI与TG、TC、LDL-C、HDL-C、BP、胰岛素抵抗指数均具有显著相关性（P <0.05），且腰围的相关系数比BMI大；与HOMA-β无相关（P＞0.05）。结论：在BMI正常的2型糖尿病腹型肥胖患者比非腹型肥胖患者表现出更显著的胰岛素抵抗。腰围与胰岛素抵抗具有较好的相关性，且其相关性高于BMI。

关键词：2型糖尿病；体重指数；腹性肥胖；胰岛素抵抗

新疆医科大学医学硕士学位论文

Insulin Resistance in normal body mass index with abdominal obesity type 2 diabetes mellitus patients

Postgraduate:Ayinuer.Muhetaer Supervisor:Yiliduosi Associate professor

Abstract

Objective:To investigate the correlation between blood lipid､blood pressure､Islet-β cell function and insulin resistance in abdominal obesity type 2 diabetes mellitus with normal Body mass index. Methods: to selecte 297 cases with normal Body mass index from 1713 type 2 diabetes mellitus patients, according to waist circumference(WC) were divided into two groups as abdominal obesity group(163 cases) and nonabdominal obesity group(134 cases). all subjects’anthropometric measurements include height､weight､waist circumference､blood pressure blood lipid ､Fasting plasma glucose､Fasting plasma glucose､glycosylated hemoglobin were collected and compare blood lipid､blood pressur､HOMA-IR､HOMA-β levels beween abdominal obesity group and nonabdominal obesity group and analyze correlation with waist circumstance and Body mass index.Results:(1) TG､TC ､LDL-C､HDL-C､BP､ HOMA-IR concentration in the abdominal group were significantly higher than the non abdominal obesity group(P <0.05); HDL-C concentration in the abdominal group were significantly lower than the non abdominal obesity group(P <0.05); After adjustment of BMI, there was still significantly difference of all paramiters between two group(P <0.05). (2) WC,BMI were related with all of the blood lipid parameters､BP､HOMA-IR.;And the coefficient of correlation of WC was higher than BMI.Conclusion:In normal Body mass index type 2 diabetes patients, abdominal obesity group shows more IR than that non abdominal obesity group.WC, BMI significantly associated with insulin resistance, and the correlation is stronger than BMI.

Key words:type 2 diabetes; body mass index; abdominal adiposity; insulin resistance;