Akinlade K S, Habila K G, Rahamon S K, Ogundeji O A
Department of Chemical Pathology, University of Ibadan/University College Hospital, Ibadan, Nigeria.
Niger J Clin Pract. 2017 Jun;20(6):767-773. doi: 10.4103/njcp.njcp_173_15.
There is at present the dearth of information on the possible contribution of insulin resistance to scores obtained from mortality risk estimation in patients with type 2 diabetes mellitus (T2DM).
This study determined the mortality risk scores in patients with T2DM and its relationship with insulin resistance.
Fasting plasma glucose, total cholesterol, high-density lipoprotein cholesterol (HDL), triglycerides, serum and urinary creatinine, glycated hemoglobin (HbA1c), serum insulin, and urinary albumin were determined in 111 T2DM patients. Thereafter, low-density lipoprotein cholesterol (LDL), quantitative insulin sensitivity check index (QUICKI), urinary albumin-to-creatinine ratio (UACR), and estimated glomerular filtration rate (eGFR) were calculated using the standard formula. Mortality risk was estimated using the validated Gargano mortality risk calculator with scores ≤0.67, 0.68-0.79, and ≥0.80 considered as low, intermediate, and high risks, respectively.
Of the total patients, 5 (4.5%), 28 (25.2%), and 78 (70.3%) patients had high, intermediate, and low mortality risk, respectively. There was no difference in the median QUICKI values when the three groups were compared. However, there was a significant elevation in the median eGFR in patients with high mortality risk compared with patients with low and intermediate mortality risks. Also, the median mortality risk score of patients with low insulin sensitivity (QUICKI ≤0.3) was similar to that obtained in patients with normal insulin sensitivity (QUICKI ≥0.31). No significant correlation was found between QUICKI and mortality risk scores.
Insulin sensitivity status does not have a direct effect on scores obtained from the Gargano mortality risk prediction model.
目前，关于胰岛素抵抗对2型糖尿病（T2DM）患者死亡风险估计得分可能产生的影响，相关信息匮乏。
本研究确定了T2DM患者的死亡风险得分及其与胰岛素抵抗的关系。
测定了111例T2DM患者的空腹血糖、总胆固醇、高密度脂蛋白胆固醇（HDL）、甘油三酯、血清和尿肌酐、糖化血红蛋白（HbA1c）、血清胰岛素和尿白蛋白。此后，使用标准公式计算低密度脂蛋白胆固醇（LDL）、定量胰岛素敏感性检查指数（QUICKI）、尿白蛋白与肌酐比值（UACR）和估计肾小球滤过率（eGFR）。使用经过验证的加尔加诺死亡风险计算器估计死亡风险，得分≤0.67、0.68 - 0.79和≥0.80分别被视为低、中、高风险。
在所有患者中，分别有5例（4.5%）、28例（25.2%）和78例（70.3%）患者具有高、中、低死亡风险。比较三组时，QUICKI值的中位数无差异。然而，与低和中度死亡风险患者相比，高死亡风险患者的eGFR中位数显著升高。此外，胰岛素敏感性低（QUICKI≤0.3）患者的死亡风险得分中位数与胰岛素敏感性正常（QUICKI≥0.31）患者的相似。未发现QUICKI与死亡风险得分之间存在显著相关性。
胰岛素敏感性状态对加尔加诺死亡风险预测模型获得的得分没有直接影响。
