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采用稳态模型评估法-胰岛素抵抗指数(HOMA-IR)评估胰岛素抵抗在失代偿性心力衰竭非糖尿病患者中的预后价值。

Prognostic Value of Insulin Resistance Assessed by HOMA-IR in Non-Diabetic Patients with Decompensated Heart Failure.

作者信息

Castillo Costa Yanina, Mauro Víctor, Fairman Enrique, Charask Adrián, Olguín Lisandro, Cáceres Leonardo, Barrero Carlos

机构信息

Santa Isabel and Bazterrica Clinics, Argentina.

Santa Isabel and Bazterrica Clinics, Argentina.

出版信息

Curr Probl Cardiol. 2023 Jun;48(6):101112. doi: 10.1016/j.cpcardiol.2022.101112. Epub 2022 Jan 7.

Abstract

The predictive value of insulin resistance in patients hospitalized with heart failure is unknown. To evaluate prognostic value of insulin resistance (defined by a HOMA IR ≥ 2.5) for the combined event of death and readmission at 90 and 365 days post discharge and to determine if there are differences according to ejection fraction. Prospective study of 156 p hospitalized for acute heart failure without diabetes. A total of 83 years, 48% female, EF ≤ 45% 48%. Of 28% presented HOMA ≥2.5. HOMA IR ≥2.5 was associated with combined event (OR 2.4; 95% CI 1.9-5.1; P: 0.02) at 90 days. A multivariate analysis demonstrated its independent predictive value (OR 2.5, 95% CI 1.1-5.8; P: 0.03). At 1 year follow-up HOMA IR did not predict events. The predictive value of HOMA-IR was not associated with ventricular function. HOMA IR index was a predictor of a combined event at 90 days in our population. It is a simple determination that could contribute to identify higher risk patients during this vulnerable post-discharge phase. These data must be validated in larger studies.

摘要

心力衰竭住院患者中胰岛素抵抗的预测价值尚不清楚。为评估胰岛素抵抗(定义为稳态模型评估的胰岛素抵抗指数[HOMA-IR]≥2.5)对出院后90天和365天死亡和再入院联合事件的预后价值,并确定根据射血分数是否存在差异。对156例非糖尿病急性心力衰竭住院患者进行前瞻性研究。共83例,48%为女性,48%射血分数(EF)≤45%。28%的患者HOMA≥2.5。HOMA-IR≥2.5与90天时的联合事件相关(比值比[OR]2.4;95%置信区间[CI]1.9 - 5.1;P = 0.02)。多因素分析显示其具有独立预测价值(OR 2.5,95%CI 1.1 - 5.8;P = 0.03)。在1年随访时,HOMA-IR不能预测事件。HOMA-IR的预测价值与心室功能无关。在我们的研究人群中,HOMA-IR指数是90天时联合事件的预测指标。这是一种简单的测定方法,有助于在出院后这个脆弱阶段识别高危患者。这些数据必须在更大规模的研究中得到验证。

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