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目的观察胰岛素抵抗与脂代谢对2型糖尿病(T2DM)合并高血压人群的影响。方法取1 708例健康体检者为对照组(Ⅰ组);1 697例T2DM患者为试验组,其中单纯T2DM 674例(Ⅱ组),T2DM合并高血压1 023例(Ⅲ组),采用全自动生化分析仪测血糖(GLU)、糖化血红蛋白(Hb A1c)、总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、载脂蛋白A1(ApoA1)、载脂蛋白B(ApoB);采用化学发光免疫分析仪测空腹胰岛素(FINS);计算稳态模型胰岛素抵抗指数(HOMA-IR)、胰岛素敏感指数(HOMA-ISI)、体质量指数(BMI)、血压、DM病史等临床资料。结果与Ⅰ组比较,Ⅱ组、Ⅲ组收缩压(SBP)、舒张压(DBP)及GLU、FINS、Hb A1c、HOMAIR、BMI、TC、TG、LDL-C、LDL-C/HDL-C、TG/HDL-C、ApoB上升;HOMA-ISI、HDL-C、ApoA1、ApoA1/ApoB下降;除HOMA-ISI、HDL-C、ApoA1、ApoA1/ApoB外,其余各指标Ⅲ组与Ⅱ组比较,有上升趋势。结论高血压、胰岛素抵抗、脂代谢紊乱是T2DM合并高血压患者发病的危险因素。
Objective To observe the effects of insulin resistance and lipid metabolism on type 2 diabetes mellitus (T2DM) with hypertension. Methods One hundred and seventy-eight healthy volunteers were selected as the control group (group Ⅰ). A total of 1 697 T2DM patients were included in the study. Among them, 674 cases of simple T2DM (group Ⅱ) and 1023 cases of T2DM complicated with hypertension (group Ⅲ) Biochemical analyzer GLU, Hb A1c, TC, TG, HDL-C, LDL-C, , Apolipoprotein A1 (ApoA1) and apolipoprotein B (ApoB). Fasting insulin (FINS) was measured by chemiluminescence immunoassay. HOMA-IR, HOMA-ISI ), Body mass index (BMI), blood pressure, DM history and other clinical data. Results SBP, DBP, GLU, FINS, Hb A1c, HOMAIR, BMI, TC, TG, LDL-C and LDL-C / HDL-C in group Ⅱ and group Ⅲ were significantly higher than those in group Ⅰ TG, HDL-C, ApoB increased; HOMA-ISI, HDL-C, ApoA1 and ApoA1 / ApoB decreased; There is an upward trend. Conclusion Hypertension, insulin resistance and lipid metabolism disorders are the risk factors of T2DM with hypertension.