Luo S H, Yang D Z, Wei X Y, Ai H Y, Lin Q Y, Liu Z Y, Ling P, Lü J, Yan J H, Yao B, Weng J P, Zheng X Y
Department of Endocrinology, the First Affiliation Hospital of University of Science and Technology (Anhui Provincial Hospital), Hefei 230001, China.
Department of Endocrinology and Metabolism, the Third Affiliation Hospital of Sun Yat-sen University, Guangdong Diabetes Prevention and Control Research Center, Guangdong Provincial Key Laboratory of Diabetology, Guangzhou 510630, China.
Zhonghua Yi Xue Za Zhi. 2019 Sep 10;99(34):2665-2669. doi: 10.3760/cma.j.issn.0376-2491.2019.34.006.
To investigate the relationship between insulin resistance (IR) and dyslipidemia in adults with type 1 diabetes (T1DM) and provide more insights on diabetes-related cardiovascular disease management. A cross-sectional study recruiting patients from Guangdong T1DM Translational Study cohort was conducted between 2011 and 2017. The patients aged ≥18 years, with a diabetes duration of ≥1 year were enrolled in the study. Plasma lipid profile data of eligible patients, including total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C) were collected and their relationships with insulin resistance were analyzed. IR in these adults with T1DM was estimated by glucose disposal rate (eGDR) calculated by a model published previously. Patients with eGDR lower than 25 percentiles were grouped as severe IR, otherwise non-severe IR. In total, 499 eligible patients were studied, among which 274 were women (54.9%). The level of eGDR was 8.43 (6.11, 10.63) mg kg(-1) min(-1) and the overall incidence of lipid disorders was 65.3% (326/499) in the study population. The result showed that eGDR was correlated with TC, TG, HDL-C and LDL-C (-0.163, -0.303, 0.170 and -0.150, respectively, all 0.05). After adjusting for gender, age and diabetes duration, eGDR was still associated with TG, TC and LDL-C (all 0.05). Stepwise multiple linear regression analysis showed that gender (female), elevated TC and declined HDL-C were independent factors associated with the severity of IR (5.651, 5.823 and 2.908, respectively, all 0.05). IR is associated with dyslipidemiain in adults with T1DM. Elevated TC and decreased HDL-C are independent associated factors for insulin resistance.
为研究1型糖尿病(T1DM)成人患者中胰岛素抵抗(IR)与血脂异常之间的关系,并为糖尿病相关心血管疾病的管理提供更多见解。2011年至2017年期间进行了一项横断面研究,该研究从广东T1DM转化研究队列中招募患者。年龄≥18岁、糖尿病病程≥1年的患者纳入本研究。收集符合条件患者的血浆脂质谱数据,包括总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)和高密度脂蛋白胆固醇(HDL-C),并分析它们与胰岛素抵抗的关系。这些T1DM成人患者的IR通过先前发表的模型计算的葡萄糖处置率(eGDR)进行评估。eGDR低于第25百分位数的患者被归为严重IR,否则为非严重IR。总共研究了499例符合条件的患者,其中274例为女性(54.9%)。研究人群中eGDR水平为8.43(6.11,10.63)mg·kg⁻¹·min⁻¹,脂质紊乱的总体发生率为65.3%(326/499)。结果显示,eGDR与TC、TG、HDL-C和LDL-C相关(分别为-0.163、-0.303、0.170和-0.150,均P<0.05)。在调整性别、年龄和糖尿病病程后,eGDR仍与TG、TC和LDL-C相关(均P<0.05)。逐步多元线性回归分析显示,性别(女性)、TC升高和HDL-C降低是与IR严重程度相关的独立因素(分别为5.651、5.823和2.908,均P<0.05)。T1DM成人患者中IR与血脂异常相关。TC升高和HDL-C降低是胰岛素抵抗的独立相关因素。