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  • 王博,刘珺,张晓燕,等.男性2型糖尿病患者胰岛素抵抗相关因素分析[J].同济大学学报(医学版),2021,42(4):534-539.    [点击复制]
  • WANG Bo,LIU Jun,ZHANG Xiao-yan,et al.Factors related to insulin resistance in male patients with type 2 diabetes mellitus[J].同济大学学报(医学版),2021,42(4):534-539.   [点击复制]
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男性2型糖尿病患者胰岛素抵抗相关因素分析
王博,刘珺,张晓燕,张雪莲,郭凯,张玄娥,顾蕾,成玮,陶沙,刘碧雯,周尊海
0
(同济大学附属杨浦医院内分泌科,上海200090;同济大学附属第十人民医院中医科,上海200072)
摘要:
目的探讨男性2型糖尿病伴胰岛素抵抗患者的临床特点及其影响因素。方法收集男性2型糖尿病患者576例,根据稳态模型胰岛素抵抗指数分为非胰岛素抵抗组248例,胰岛素抵抗组328例。比较两组一般临床资料及实验室数据和两组其他疾病构成比的差异,两变量相关分析胰岛素抵抗与一般临床指标的相关性,并用二元Logistic回归方法分析胰岛素抵抗与影响因素的相关性。结果男性2型糖尿病伴胰岛素抵抗患者年龄较轻,血压较高,体重、体重指数、腰围、臀围、腰臀比、内脏脂肪、皮下脂肪及总脂肪均高于非胰岛素抵抗组(均P<0.001),实验室数据结果提示,胰岛素抵抗组糖化血红蛋白、空腹、餐后2h血糖、胰岛素、C肽均高于非胰岛素抵抗组(均P<0.001),转氨酶、尿酸、总胆固醇、三酰甘油较非胰岛素抵抗组高,差异有统计学意义(P<0.01、P<0.01、P<0.05、P<0.01)。在其他疾病构成上,胰岛素抵抗组肥胖症、高血压病、高脂血症,高尿酸血症比例高于非胰岛素抵抗组(P<0.01、P<0.01、P<0.01、P<0.05)。相关分析提示,胰岛素抵抗指数与腰围(r=0.119,P=0.004)、腰臀比(r=0.117,P=0.005)、内脏脂肪(r=0.089,P=0.044)和总脂肪(r=0.095,P=0.032)呈正相关关系。二元Logistic回归分析显示,内脏脂肪(OR=1.007, P=0.028)、皮下脂肪(OR=1.009,P=0.014)、三酰甘油(OR=1.147,P=0.046)与胰岛素抵抗有关。结论男性2型糖尿病伴胰岛素抵抗患者肥胖症、高血压、高脂血症、高尿酸血症发生比例高于非胰岛素抵抗组。内脏脂肪、皮下脂肪、三酰甘油与胰岛素抵抗有关。
关键词:  2型糖尿病  胰岛素抵抗  内脏脂肪  皮下脂肪
DOI:10.12289/j.issn.1008-0392.20520
投稿时间:2020-12-04
基金项目:上海市自然科学基金(18ZR1435800)
Factors related to insulin resistance in male patients with type 2 diabetes mellitus
WANG Bo,LIU Jun,ZHANG Xiao-yan,ZHANG Xue-lian,GUO Kai,ZHANG Xuan-e,GU Lei,CHENG Wei,TAO Sha,LIU Bi-wen,ZHOU Zun-hai
(Dept.of Endocrinology, Yangpu Hospital, School of Medicine, Tongji University, Shanghai 200090, China;Dept. of Traditional Chinese Medicine, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai 200072, China)
Abstract:
ObjectiveTo investigate the clinical characteristics and influencing factors of insulin resistance in male patients with type 2 diabetes mellitus (T2DM). Methods A total of 576 male patients with T2DM were enrolled in the study, including 328 patients with insulin resistance and 248 patients without insulin resistance according to HOMA-IR. The general clinical data and laboratory findings were compared between the two groups. The factors related to insulin resistance were analyzed by binary logistic regression method. Results The age was younger, the blood pressure, body weight, BMI, waist circumference, hip circumference, waist hip ratio, visceral fat, subcutaneous fat and total fat in insulin resistance group were higher than those in non insulin resistance group(P<0.001); and the levels of blood glucose, insulin and C-peptide were significantly higher than those in non insulin resistance group(P<0.001). The levels of transaminase, uric acid, total cholesterol and triglyceride in insulin resistance group were significantly higher than those in non insulin resistance group(P<0.01 or P<0.05). The proportion of obesity, hypertension, hyperlipidemia and hyperuricemia in insulin resistance group was higher than that in non insulin resistance group(P< 0.01 or P< 0.05). Correlation analysis showed that insulin resistance index was positively correlated with waist circumference(r=0.119, P=0.004), waist hip ratio(r= 0.117, P= 0.005), visceral fat(r=0.089, P=0.044) and total fat(r=0.095, P=0.032). Binary logistic regression analysis showed that visceral fat(OR=1.007, P=0.028), subcutaneous fat(OR=1.009, P=0.014) and TG(OR=1.147, P=0.046) were independent risk factors of insulin resistance. ConclusionThe incidence of obesity, hypertension, hyperlipidemia and hyperuricemia in male T2DM patients with insulin resistance is higher than that in patients without insulin resistance. Visceral fat, subcutaneous fat and triglyceride level are risk factors of insulin resistance.
Key words:  type 2 diabetes  insulin resistance  visceral fat  subcutaneous fat

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