不同组别血液透析患者的胰岛素抵抗与心血管风险：一项多中心研究。

Insulin Resistance and Cardiovascular Risks in Different Groups of Hemodialysis Patients: A Multicenter Study.

机构信息

School of Nutrition and Health Sciences, Taipei Medical University, Taipei, Taiwan.

Department of Nutrition and Health Sciences, Chinese Culture University, Taipei, Taiwan.

出版信息

Biomed Res Int. 2019 Jun 11;2019:1541593. doi: 10.1155/2019/1541593. eCollection 2019.

DOI:10.1155/2019/1541593

PMID:31309101

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6594339/

Abstract

BACKGROUND

To investigate the association between insulin resistance (IR) and cardiovascular disease (CVD) risks among hemodialysis patients.

METHODS

We conducted a cross-sectional study between 2013 and 2017, on 384 hemodialysis patients from seven hospital-based-dialysis centers. HOMA-IR is classified according to median value. The CVD risks were defined by the K/DOQI Guidelines. Logistic regression analysis was used.

RESULTS

Patients' age was 60.9 ± 11.8, 58.1% men, and 40.3% overweight/obese. The median of HOMA-IR was 5.4, 82.8% high systolic blood pressure, and 85.7% hyperhomocysteinemia. In multivariate analysis, IR was significantly associated with higher odds of low high-density lipoprotein cholesterol, high triglyceride, and impaired fasting glucose in groups of normal weight, overweight/obese, nondiabetes, diabetes, and overall sample. IR linked with elevated high-sensitive C-reactive protein in normal weight patients (odd ratio, OR=2.21, 95% confidence interval, 1.16-4.22, p < .05), with hypoalbuminemia in normal weight patients (OR=8.31, 95% CI, 2.35-29.37, p < .01), in nondiabetes patients (OR=6.59, 95% CI, 1.81-23.95, p < .01), and overall sample (OR=3.07, 1.51-6.23, p < .01).

CONCLUSIONS

The level of IR and prevalence of CVD risks were high in hemodialysis patients. IR was independently associated with CVD risks.

摘要

背景

研究胰岛素抵抗（IR）与血液透析患者心血管疾病（CVD）风险之间的关系。

方法

我们于 2013 年至 2017 年在 7 家医院透析中心进行了一项横断面研究，纳入 384 名血液透析患者。根据中位数将 HOMA-IR 进行分类。CVD 风险由 K/DOQI 指南定义。采用 logistic 回归分析。

结果

患者年龄为 60.9±11.8 岁，58.1%为男性，40.3%超重/肥胖。HOMA-IR 的中位数为 5.4，82.8%为高血压，85.7%为高同型半胱氨酸血症。多变量分析显示，在正常体重、超重/肥胖、非糖尿病、糖尿病和总体样本中，IR 与低高密度脂蛋白胆固醇、高甘油三酯和空腹血糖受损的可能性更高相关。IR 与正常体重患者的高敏 C 反应蛋白升高相关（比值比，OR=2.21，95%置信区间，1.16-4.22，p<.05），与正常体重患者的低白蛋白血症相关（OR=8.31，95%置信区间，2.35-29.37，p<.01），与非糖尿病患者相关（OR=6.59，95%置信区间，1.81-23.95，p<.01），与总体样本相关（OR=3.07，95%置信区间，1.51-6.23，p<.01）。