尿毒症脂质代谢紊乱发生机制的进一步研究

采用口服葡萄糖耐量试验方法（OGTT）,检测50倒尿毒症患者胰岛素糖代谢调节作用活性,分析胰岛素拮抗与尿毒症脂质代谢紊乱的关系。结果显示:（1）本组尿毒症者存在明显的脂质代谢紊乱,表现为血浆甘油三酯（TG）、低密度脂蛋白胆固醇（LDL—C）水平增高,高密度脂蛋白胆固醇（HDL—C）水平低下,LDL—C/HD—C比值增高;（2）胰岛素拮抗组较非胰岛素拮抗组其LDL—C水平和LDL—C/HDL—C比值显著增高;（3）相关分析显示LDL—C与胰岛素敏感指数（ISI）呈负相关,与胰岛素反应曲线下面积（AUCINS）成正相关;LDL—C/HD—C则与ISI、机体糖利用率（M）成负相关,而与糖反应曲线下面积（AUCG）成正相关。结论:胰岛素拮抗及其相关的高胰岛素血症、糖耐量异常与尿毒症脂质代谢紊乱有关,但其机制有待于进一步探讨。

Further Study of the Mechanism of Dyslipidemia in Uremia

With use of the oral glucose tolerance test, we investigated the insulin glycoregulatory activity in 50 uremic patients to analyse the association between insulin resistance and the dyslipidemia in uremia. It showed that (1) Dyslipidemia, such as increased TG and LDL - C levels, increased LDL - C/HDL - C ratio and decreased HDL - C levels, existed in most of our uremic patients; (2) The LDL - C level and LDL ?C/HDL ?C ratio in the insulin resistant group were significantly higher than those in non - insulin resistant one; (3) Simple regression showed that LDL - C had significant negative correlation with ISI, significant positive correlation with AUCINS; LDL - C/HDL - C ratio had significant negative correlation with ISI and M, significant positive correlation with AUCG. Conclusion; Insulin resistance, hyperinsulinemia and glucose intolerance had some definite association with the uremic dyslipidemia, but its mechanism(s) should be studied further.