不稳定型心绞痛患者血浆胰岛素生长因子-1与胰岛素抵抗的关系

目的:探讨无糖尿病的不稳定型心绞痛(UAP)患者血浆胰岛素(INS)样生长因子(IGF)-1与INS抵抗(IR)的关系。方法:42例无糖尿病的UAP患者(UAP组)与30例非冠心病患者(对照组)比较,行75g葡萄糖口服耐量试验,测定空腹、餐后30min、餐后120min血糖、INS、IGF-1水平。结果:UAP组和对照组伴IR患者分别为26例和12例(P<0·05),UAP组中,伴IR与不伴IR者比较,空腹、餐后30min、餐后120minIGF-1明显降低(均P<0·05);HOMA-INS敏感指数(HOMA-ISI)、HOMA-IR指数(HOMA-IRI)分别明显增高和降低(P<0·05)。相关分析显示HOMA-IRI与体质指数(BMI)呈正相关(r=0·353,P<0·05);与空腹及餐后120minIGF-1和IGF-1曲线下面积(IGF-1AUC)呈负相关。多重逐步回归分析显示,HOMA-IRI=0·45722BMI-0·34285IGF-1空腹。结论:IGF-1与无糖尿病的UAP患者IR存在密切关系。

Relationship between insulin-like growth factor-1 and insulin resistance in non-diabetic unstable angina

Objective:To assess the relationship between insulin-like growth factor-1 and insulin resistance in patients of unstable angina (UAP) without diabetes mellitus. Method:Forty-two patients with UAP were enrolled as UAP group, another 30 patients who claimed of chest pain but without coronary heart disease through coronary angiography were selected as control group. All patients were given an oral glucose tolerance test with 75 g glucose, and 0', 30' and 120' later blood samples were tested for glucose, insulin and IGF-1 plasma levels. Result:Cases of 26(61.9%) and 12(40%) IR existed in the UAP group and the control group. 0'IGF-1, 30'IGF-1, 120'IGF-1 were significantly different between the IR and the non-IR patients in the UAP group (P<0.05); HOMA-IRI was significantly increased and HOMA-ISI was decreased (P<0.05). Multiple regression analysis of HOMA-IRI showed that it was positively correlated with BMI and negatively with 0'IGF-1.Conclusion:The low IGF-1 level promots IRI while HOMA-IRI and INS are significantly increased in the UAP patients without diabetes mellitus.