Department of Dermatolog, Mazandaran University of Medical Sciences, Sari, Iran.
Eur Rev Med Pharmacol Sci. 2011 Oct;15(10):1196-201.
Lipodystrophy is a potential clinical complication induced by insulin therapy, and it is believed that its frequency has been reduced by using recombinant human insulin. Aim of this study was to determine the frequency of recombinant human insulin induced lipodystrophy in diabetic patients.
This cross sectional study was done on 220 diabetics referring to Imam Educational Hospital of Sari Township in 2007-2008 who had been under treatment with recombinant human insulin at least three months before. First, the anthropologic and clinical features of the patients were recorded in questionnaire, then all of the patients were examined clinically for lipodystrophy. In all patients, glycosylated hemoglobin (HbA1C) was measured for control of the blood glucose. The obtained data were analyzed by the descriptive statistical methods, t-test and 2 test.
From the total 220 diabetics under study, 35 (15.9%) had insulin induced lipodystrophy, of them 32 (14.5%) had lipohypertrophy and 3 (1.4%) with lipoatrophy. Factors such as age, sex, level of education, body mass index (BMI), type of diabetes, period of using insulin and injection site had significant influence in development of insulin induced lipodystrophy (p<0.05).
Findings of this study revealed that despite using a recombinant human insulin, the frequency of the lipodystrophy particularly of lipohypertrophy still remained high level. Therefore, a regular examination of the diabetic patients for this complication is necessary, specially in the individuals who have a defective control on their blood glucose level.
脂肪营养不良是胰岛素治疗引起的一种潜在临床并发症,人们认为使用重组人胰岛素已经降低了其发生率。本研究旨在确定糖尿病患者中重组人胰岛素引起的脂肪营养不良的发生率。
本研究为 2007 年至 2008 年在萨里镇伊玛目教育医院就诊的 220 名糖尿病患者的横断面研究,这些患者在入组前至少三个月内使用重组人胰岛素治疗。首先,通过问卷调查记录患者的人体测量学和临床特征,然后对所有患者进行临床检查以确定脂肪营养不良。所有患者均测量糖化血红蛋白(HbA1C)以控制血糖。使用描述性统计方法、t 检验和卡方检验对获得的数据进行分析。
在所研究的 220 名糖尿病患者中,有 35 名(15.9%)出现了胰岛素引起的脂肪营养不良,其中 32 名(14.5%)出现了脂肪增生,3 名(1.4%)出现了脂肪萎缩。年龄、性别、受教育程度、体重指数(BMI)、糖尿病类型、使用胰岛素的时间和注射部位等因素对胰岛素引起的脂肪营养不良的发生有显著影响(p<0.05)。
本研究结果表明,尽管使用重组人胰岛素,但脂肪营养不良,特别是脂肪增生的发生率仍然很高。因此,有必要定期对糖尿病患者进行这种并发症的检查,特别是对血糖控制不佳的患者。