痛风患者代谢指标及胰岛素抵抗的研究

Relationship between metabolicindices and insulin resistance in patients with gout

关键词:  痛风  代谢指标  胰岛素抵抗

Key words:  gout  metabolicindice  insulin resistance

摘要:

［目的］了解痛风患者的代谢指标及胰岛素抵抗(IR)的情况,并探讨痛风患者胰岛素抵抗的影响因素。［方法］106例痛风患者为研究对象,测定空腹血糖(FPG)、空腹胰岛素（FINS）、血脂、血尿酸(Ua)及餐后2 h血糖(2hPG)、胰岛素(2hINS)，分析痛风组与尿酸正常组的上述代谢指标，稳态模型（HOMA）计算胰岛素抵抗指数(IRI)。并对影响痛风患者IR的诸多因素进行多元线性逐步回归分析。［结果］痛风患者体重指数(BMI)、空腹胰岛素、甘油三酯（TG）、低密度脂蛋白（LDL）及IRI分别为：(25.0±2.0)kg/m²、(14.26±3.53)mU/L、(2.35±0.71)mmol/L、(3.07±0.64)mmol/L、3.36±0.83，上述指标较尿酸正常组明显增高，痛风患者高密度脂蛋白（HDL）（1.47±0.55）mmol/L较尿酸正常组明显降低，2组间上述指标比较差异有显著性意义（P<0.05，P<0.01）。痛风患者IR的Pearson相关分析结果示：IRI与年龄、BMI、TG、TC、LDL、UA呈正相关(P<0.05或P<0.01)，与HDL呈负相关(P<0.01)。多元线性逐步回归分析提示BMI、UA、TG是影响痛风患者IR的独立危险因素。［结论］痛风患者存在IR，且BMI、UA、TG是影响痛风患者IR的重要因素。

Abstract:

［Objective］To investigate the relationship between metabolicindices and insulin resistance in patients with gout .［Methods］Fasting plasma glucose (FPG),2 h plasma glucose(2hPG),fasting serum insulin (FINS),2 h serum insulin(2hINS),Total cholesterol(CH), Triglyceride（TG）,High density lipoprotein cholesterol（HDL）,Low density lipoprotein cholesterol（LDL）and Ua were determined in 106 patients with gout, 80 normal control group . HOMA-IR(IRI) was calculated at the same time. A multiple linear stepwise regression analysis was used.to analyze the risk factor related to IR.［Results］The levels of Body mass index （BMI）,FINS,TG,LDL and IRI were were significantly higher in the gout patients than those normal control group (P<0.05, P<0.01) . HDL was significantly lower in the gout patients than those normal control group (P<0.05) .In the group of gout ,Pearson correlation analysis indicated that IRI was positively correlated with Age,BMI,TG,TC,LDL,Ua, but IRI was negativly correlated to HDL.A multiple linear stepwise regression analysis indicated that BMI，TG，Ua were independent factors for IRI .［Conclusions］There is the higher insulin resistance in the gout,BMI，TG，Ua might play an important role in pathogensis of insulin resistance.