超重、肥胖对2型糖尿病患者凝血及代谢指标的影响（英文）

目的：了解超重、肥胖对2型糖尿病患者凝血及代谢紊乱的影响。方法：选择初诊为2型糖尿病的患者248例,根据人体质量指数（BMI）分为正常BMI对照组（95例）、超重组（87例）、肥胖组（66例）,均测定血脂、血糖、空腹胰岛素等相关指标,计算胰岛素抵抗指数（HOMA-IR）,并进行统计学处理。结果：与正常BMI对照组相比,超重组、肥胖组血浆纤维蛋白原（fg）（3.37±0.55）g/L比（4.04±0.70）g/L比（5.20±0.69）g/L]、尿微量白蛋白（UMA）（14.46±8.90）mg/g比（47.33±42.54）mg/g比（104.45±60.78）mg/g]、空腹血糖（FBG）（7.15±0.97）mmol/L比（8.84±1.81）mmol/L比（10.06±2.28）mmol/L]、空腹胰岛素（FINS）（10.09±8.21）IU/ml比（14.33±15.55）IU/ml比（19.69±10.86）IU/ml]、HOMA-IR（3.19±2.59）比（5.51±5.38）比（8.48±4.62）]及血甘油三酯（TG）、总胆固醇（TC）、低密度脂蛋白（LDL-C）水平均明显升高,且随肥胖程度的增加而呈上升趋势,而血浆凝血酶原时间（PPT）（13.33±0.69）s比（12.74±0.69）s比（11.43±0.53）s]、血浆活化部分凝血活酶时间（APTT）（37.32±2.31）s比（36.55±2.41）s比（34.61±1.53）s]、HDL-C（1.54±1.12）mmol/L比（1.27±0.41）mmol/L比（1.09±0.28）mmol/L]水平均明显降低,且随肥胖程度的加深而呈下降趋势（P均〈0.05）。结论：超重及肥胖加重2型糖尿病凝血功能及代谢障碍,并加重胰岛素抵抗的程度,且此异常随肥胖程度的加深而更加严重。

Influence of obesity and overweight on blood coagulation and metabolic indexes in patients with type 2 diabetes mellitus

Objective:To study influence of overweight and obesity on blood coagulation and metabolic disorders in patients with type 2 diabetes mellitus(T2DM).Methods: total of 248 preliminary diagnosed T2DM patients were selected.According to body mass index(BMI),they were divided into normal BMI control group(n=95),overweight group(n=87) and obesity group(n=66).Blood lipids,blood glucose and fasting insulin(FINS) were measured in all patients and homeostasis model-insulin resistance index(HOMA-IR) was calculated then.Statistical analysis was performed.Results:Compared with normal BMI control group,there were significant increase in fibrinogen (3.37±0.55) g/L vs.(4.04±0.70) g/L vs.(5.20±0.69) g/L],urine microalbumin (14.46±8.90) mg/g vs.(47.33±42.54) mg/g vs.(104.45±60.78) mg/g],fasting blood glucose (7.15±0.97) mmol/L vs.(8.84±1.81) mmol/L vs.(10.06±2.28) mmol/L],FINS (10.09±8.21) IU/ml vs.(14.33±15.55) IU/ml vs.(19.69±10.86) IU/ml],HOMA-IR(3.19±2.59) vs.(5.51±5.38) vs.(8.48±4.62)],TG,TC and LDL-C levels in overweight group and obesity group,and the more BMI patients were,the higher these indicators were;There were significant decrease in plasma prothrombin time (13.33±0.69)s vs.(12.74±0.69)s vs.(11.43±0.53)s],activated partial thromboplastin time (37.32±2.31)s vs.(36.55±2.41)s vs.(34.61±1.53)s] and HDL-C (1.54±1.12) mmol/L vs.(1.27±0.41) mmol/L vs.(1.09±0.28) mmol/L] in overweight group and obesity group(P<0.05 all).Conclusion:Overweight and obesity aggravate coagulation and metabolic disorders in patients with type 2 diabetes mellitus.It also aggravates degree of insulin resistance,the more BMI patients are,the more serious they are.