2型糖尿病患者糖脂代谢、胰岛素降解酶活性情况及其与胰岛素抵抗的关系

摘要

目的 探讨2型糖尿病(T2DM)患者的糖脂代谢及胰岛素降解酶(IDE)活性及其与胰岛素抵抗(IR)的关系.方法 对150例T2DM患者(糖尿病组)及150例健康体验者(对照组)进行问卷调查、体格检查,并检测糖脂代谢指标和IDE活性,同时计算IR指数(HOMA-IR).比较两组糖脂代谢指标及IDE活性,并分析糖脂代谢指标及IDE活性与HOMA-IR的相关性.结果 糖尿病组患者体质指数(BMI)、DBP、TG、TC、LDL-C、FBG、餐后2 h血糖(2hPG)、空腹胰岛素(FINS)、HOMA-IR和IDE活性均高于对照组(P<0.05),HDL-C水平低于对照组(P<0.05).相关分析结果显示,HOMA-IR与BMI、TG、TC、LDL-C、FBG、2hPG、FINS、IDE活性呈正相关,与HDL-C呈负相关(P均<0.05);多元线性逐步回归结果显示,IDE活性、TG、LDL-C是影响HOMA-IR升高的独立危险因素(P<0.05).结论 T2DM患者存在明显糖脂代谢紊乱,且IDE活性升高.IDE活性升高是T2DM患者发生胰岛素抵抗的危险因素之一.%Objective To investigate the relationship of glycolipid metabolism and insulin-degrading enzyme(IDE) with insulin resistance(IR) in patients with type 2 diabetes mellitus (T2DM).Methods A total of 150 patients with T2DM were selected as diabetes group and 150 healthy individuals as control group.Questionnaire survey,physical examination,and detection of glycolipid metabolism index and IDE activity were conducted.Meanwhile,the homeostasis model of assessment for insulin resistance index(HOMA-IR) was calculated.The glycolipid metabolism index and IDE activity were compared between the two groups,and the correlation of glycolipid metabolism index and IDE activity with HOMA-IR was analyzed.Results Body mass index(BMI),levels of DBP,TG,TC,LDL-C,FBG,2h postprandial plasma glucose (2hPG) and fasting insulin(FINS),HOMA-IR,and IDE activity were higher while the level of HDL-C was lower in the diabetes groups compared to the control group(P<0.05).Correlation analysis showed that HOMA-IR positively correlated with BMI,levels of TG,TC,LDL-C,FBG and 2hPG,FINS,and IDE activity,but negatively correlated with the level of HDL-C(all P<0.05).Multiple linear regression analysis indicated that IDE activity,levels of TG and LDL-C were independent risk factors for HOMA-IR elevation(P<0.05).Conclusion T2DM patients have obvious disorder of glucolipid metabolism as well as increase in the IDE activity.Elevation of IDE activity is one of the risk factors for the incidence of IR in patients with T2DM.