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目的了解代谢综合征(metabolic syndrome,MS)患者血胰岛素样生长因子1(IGF1)水平及其与MS的关系。方法按2005年国际糖尿病联盟(IDF)颁布的MS定义,将老年患者465例分为MS组255例和对照组210例。查空腹血糖、胰岛素、C肽、餐后2 h血糖、血脂全套、血IGF1并计算体质指数(BMI)。两组按是否并存糖尿病再分为糖尿病和非糖尿病两个亚组。结果(1) MS组除高密度脂蛋白胆固醇(HDL-C)低于对照组外,其他血液指标均高于对照组(P<0．01);两组IGF1水平与年龄、BMI均呈负相关(P<0．05)。(2)MS糖尿病组IGF1(163．5±128．1)μg／L、胰岛素(14．3±10．5)mU／L高于MS非糖尿病组(114．0±52．6)μg／L、(8．46±4．4)mU／L,C肽(1．1±0．4)μg／L低于MS非糖尿病组(2．5±0．4)μg／L,均为P<0．01;IGF1水平与胰岛素、C肽无相关性,与冠心病呈负相关(P<0．05)。(3)对照糖尿病组IGF1(129．2±49．1)μg／L低于对照非糖尿病组(136．6±80．5)μg／L,胰岛素(14．1±11．7)mU／L、C肽(3．28±2．23)μg／L高于对照非糖尿病组(10．3±6．1)mU／L、(2．9±1．7)μg／L,P<0．01或0．05。对照组IGF1与C肽负相关,与甘油三酯正相关;对照糖尿病组IGF1与胰岛素、C肽负相关(均为P<0．01或0．05)。结论MS患者存在高血IGF1现象,这与单纯糖尿病患者低IGF1不同;MS患者IGF1水平较低时发生冠心病的机率较高。
Objective To investigate the level of insulin-like growth factor 1 (IGF1) in patients with metabolic syndrome (MS) and its relationship with MS. Methods According to MS definition promulgated by International Diabetes Federation (IDF) in 2005, 465 elderly patients were divided into 255 cases in MS group and 210 cases in control group. Check fasting blood glucose, insulin, C-peptide, 2 h postprandial blood glucose, blood lipids, blood IGF1 and calculate body mass index (BMI). Two groups were divided into two subgroups of diabetes and non-diabetes according to whether coexisting diabetes mellitus. Results (1) In addition to HDL-C in MS group, other blood indexes were higher than those in control group (P <0.01). The levels of IGF1 in both groups were negative with age and BMI Related (P <0.05). (2) IGF1 (163.5 ± 128.1) μg / L and insulin (14.3 ± 10.5) mU / L in MS diabetic group were significantly higher than those in MS non-diabetic group (114.0 ± 52.6) μg / L, (8.46 ± 4.4) mU / L, and C peptide (1.1 ± 0.4) μg / L were lower than those of non-diabetic MS patients P <0.01; There was no correlation between IGF1 level and insulin and C-peptide, but negatively correlated with coronary heart disease (P <0.05). (3) The levels of IGF1 (129.2 ± 49.1) μg / L in the control diabetes group were lower than those in the control non-diabetic group (136.6 ± 80.5) μg / L and insulin (14.1 ± 11.7) mU / L, C peptide (3.28 ± 2.23) μg / L were higher than those in control non-diabetic patients (10.3 ± 6.1) mU / L, (2.9 ± 1.7) μg / L, P < 0.01 or 0.05. In the control group, IGF1 was negatively correlated with C peptide and positively correlated with triglyceride. IGF1 in insulin control group was negatively correlated with insulin and C peptide (all P <0.01 or 0.05). Conclusion MS patients with high blood IGF1 phenomenon, which is different from low-IGF1 in patients with simple diabetes mellitus; MS patients with low IGF1 levels higher incidence of coronary heart disease.