2型糖尿病眼肌麻痹患者胰岛素抵抗、脂代谢紊乱与神经病变的关系

目的探讨2型糖尿病眼肌麻痹患者胰岛素抵抗、脂代谢紊乱与神经病变的关系。方法对56例2型糖尿病眼肌麻痹患者(T2DM+OMP)、56例2型单纯糖尿病患者(T2DM)及56例健康对照者(HC)进行隔夜空腹12 h血糖(FBG)、胰岛素(FINS)、糖化血红蛋白(HbA1c)、血清总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)检测并进行分析,用稳态模型方法评估各组人群空腹胰岛素抵抗指数(HOMA-IR)、胰岛素敏感指数(ISI)及胰岛β细胞功能(HOMA-β)。结果 T2DM+OMP组FBG、FINS、HOMA-IR、HbA1c、TC、TG、LDL-C浓度均显著高于T2DM组及HC组(P均<0.01),ISI、HOMA-β、HDL-C血清浓度显著低于T2DM组及HC组(P均<0.01)。T2DM组FBG、FINS、HOMA-IR、HbA1c、TC、TG浓度高于HC组(P均<0.05),T2DM组ISI、HOMA-β、HDL-C浓度低于HC组(P均<0.01)。结论胰岛素抵抗、脂代谢紊乱极大地促进了糖尿病微血管及神经病变的发生和发展,控制血糖、改善脂代谢异常、减少胰岛素抵抗、保护胰岛β细胞功能对预防和治疗2型糖尿病神经病变有指导意义。

Relationship between insulin resistance, lipid disorders and neuropathy in patients with type 2 diabetic ocular muscles palsy

Objective It is to investigate the relationship among insulin sensitivity,insulin secretion,insulin resistance,lipid disorders and neuropathy in patients with type 2 diabetic ocular muscles palsy.Methods Venous blood samples were collected from 56 glucose of patients with diabetic ocular muscles palsy,56 glucose of patients without complication and 56 healthy controls(healthy control group).The glycosylated hemoglobin 1c(HbA1c),fasting blood glucose(FBG),fasting insulin(FINS),total cholesterol(TC),triglycerides(TG),high-density lipoprotein cholesterol(HDL-C),and low-density lipoprotein cholesterol(LDL-C) were measured after fasting for 12h.The correlation analysis was performed among FBG,HbA1c,FINS and plasma lipid levels in the three group.Homeostasis model assessment was used to evaluate the status of insulin resistance(HOMA-IR),the insulin sensitivity index(ISI) and basal insulin secretion(HOMA-β).Results The levels of plasma FBG,FINS,HbA1c,TC,TG,LDL-C were significantly higher in T2DM+OMP group than that in T2DM and HC group(P<0.01).ISI,HOMA-βand the levels of plasma HDL-C were significantly lower in T2DM+OMP group than that in T2DM and HC group(P<0.01).The levels of plasma FBG,INS,HbA1c,TC,TG,LDL-C were significantly higher in T2DM group than that in HC group(P<0.05).ISI,HOMA-βand the levels of plasma HDL-C were significantly lower in T2DM group than that in HC group(P<0.01).Conclusion Insulin resistance and lipid disorder in patients with type 2 diabetic has greatly contributed to the occurrence and development of microvascular disease.It is significance for the prevention and cure the diabetic complicated peripheral nerve disorders to control blood glucose,improve the abnormal metabolism of lipid,reduce insulin resistance and protection β-cell function.