冠心病住院患者不同胰岛素抵抗水平下多种危险因素对比研究

摘要

Objective: To comparatively analyze the multiple risk factor distribution for different level of insulin resistance (HOMA IR) in patients with coronary artery disease (CAD). n Methods: A total of 203 in-hospital patients were divided into 2 groups, CAD group, n=132 and Control group, n=71. According to the quartile value of HOMA IR, the patients in Control group were further divided as following: 25th percentile (1.53), 50th percentile (3.46) and 75th percentile (5.14). The patients in CAD group were further divided into 4 sub-groups:①HOMA IR ≤ 1.53, n=28, ②HOMA IR: 1.54-3.46, n=25, ③HOMA IR: 3.47-5.13, n=28 and ④ HOMA IR ≥5.14, n=51. The multiple risk factors of insulin resistance in CAD patients were studied by Homeostasis model assessment. n Results: In CAD group, the weight, waist-to-hip ratio (WHR), waist circumference, LDL-C, fasting glucose, 2h glucose and fasting insulin level were increased in Sub-group④ than Sub-group①; the fasting TC, LDL-C, fasting glucose, 2h glucose and fasting insulin level were increased in Sub-group④than Sub-group②, P<0.05-0.01. n Conclusion: The elevated weight, WHR and LDL-C level were the major features of insulin resistance in CAD patients at that area.%目的：比较分析冠心病住院患者不同胰岛素抵抗水平下多种危险因素的分布特点。n　　方法：选取住院患者203例，其中冠心病患者132例（冠心病组）；对照组71例，并根据对照组71例患者的胰岛素抵抗指数（HOMA IR）四分位值[25百分位（1.53），50百分位（3.46），75百分位（5.14）]将132例冠心病患者分为四组：即：HOMA IR≤1.53为第一组（n=28）；HOMA IR：1.54~3.46为第二组（n=25）；HOMA IR：3.47~5.13为第三组（n=28）；HOMA IR≥5.14为冠心病胰岛素抵抗组（第四组，n=51）。运用稳态模式法评价胰岛素抵抗对冠心病多种危险因素分布的影响。n　　结果：第四组与第一组比较，体重、腰臀比、腰围、低密度脂蛋白胆固醇（LDL-C）、空腹血糖水平、餐后2 h血糖水平及空腹胰岛素水平均增加；与第二组比较，空腹总胆固醇、LDL-C、空腹血糖水平、餐后2 h血糖水平及空腹胰岛素水平均增加，差异均有统计学意义（P均＜0.05~0.01）。n　　结论：体重和腰臀比增加、LDL-C、总胆固醇升高是该地区冠心病合并胰岛素抵抗住院患者的主要特征。