老年糖尿病患者胰岛素抵抗与血清同型半胱氨酸水平的研究

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1、老年糖尿病患者胰岛素抵抗与血清同型半胱氨酸水平的研宄李素兰杨瑞平(广西壮族自治区人民医院内分泌代谢干部病房530021)【】FI的：观察胰岛素泵治疗对老年2型糖鉍病患者血淸同型半胱氨酸(Hey)水平的影响，并探讨其变化与胰岛素抵抗的相关性。方法：选取正常糖耐量者(NGT)47例，老年T2DM患者46例，T2DM组治疗前后检测血糖，血脂，血淸Hey等相关代谢指标。结果:①T2DM组血淸Hey水平(12.30±4.17)μmol/L明显高于NGT组(9.42±2.13)μmol/L,差异有统计学意义(t=2.13

2、0,p<0.05)o②T2DM组经CSII治疗2周后空腹血糖(FPG)及餐后2h血糖(2hPG)均明显下降，差异均有统计学意义(p<0.01)。同时稳态模型评估的胰岛素抵抗指数(HOMA-IR)显著下降。血清Hey水平显著下降，差异有统计学意义(t=2.374,p<0.05)o③Pearson相关分析显示，T2DM组血清Hey水平与H0MA-IR呈正相关(r=0.342/p<0.05)o④多元逐步回归分析显示HOMA-IR是影响血清Hey的独立相关因素。结论：老年T2DM患者经短期CSII治疗后胰岛素抵抗明显改善，同时血清H

3、ey水平显著卜降，HOMA-IR与呈血清Hey水平呈正相关。【关键词】胰岛素抵抗胰岛素泵同型半胱氨酸2型糖尿病【屮图分类号】R587.1【】A【】2095-1752(2014)16-0072-02Effectofshort-termcontinuoussubcutaneousinsulininfusiononthelevelofhomocysteicacidintype2diabeticmellitus[Abstract]Objective：Toobservethelevelofandtoobservetheeffectofshort—termco

4、ntinuoussubcutaneousinsulininfusion(CSII)onHeyinT2DM，andtoinvestigatetheassociationbetweeninsulinresistanceandHey.Methods：45casesasNGTgroupand45T2DMpatientswereinvolvedinthisstudy.TheT2DMpatientsweretreatedwithCSIIfor2week.BeforeandafterCSIItherapy,75goralglucosetolerancetest(

5、OGTT)wereperformed.Thelevelofplasmaglucoseandinsulinwereexaminedrespectively，serumHeyandotheritemswerealsomeasured.Results：①SerumHeylevelsintheT2DMgroup(12.30±4.17)μmol/LwerehigherthantheNGTgroup(9.42±2.13)μmol/L(t=2.130,p<0.05).②IntheT2DMgroup，therewasa

6、significantdecreaseinfastingplasmaglucose(FPG)and2hplasmaglucoseafterglucoseoverload(2hPG)(P<0.01),asignificantdecreaseinhomeostasismodelassessmentforinsulinresistance(HOMA-IR)values［2.00(1.34〜2.62)vsl.31(0.91〜1.80)］，serumHeyconcentrationsweresignificantlydecreased(t=2.374,

7、p<0.05)afterCSIItreatmentfor2weeks.③IntheT2DMgroup,serumHeylevelspositivelycorrelatedwithHOMA-IR(r=0.342,p<0.05)•④ThemultipleregressionanalysisshowedthatHOMA-IRwasanindependentrelatedfactorintheinfluenceoftheHeyconcentrations.Conclusion：IntheT2DMgroupinsulinresistancewas

8、improvedandserumHeyconcentrationsweresignificantlydecreasedaf