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用于区分绝经后女性糖尿病前期和糖尿病的胰岛素抵抗诊断标志物。

Diagnostic markers of insulin resistance to discriminate between prediabetes and diabetes in menopausal women.

作者信息

Cybulska A M, Schneider-Matyka D, Wieder-Huszla S, Panczyk M, Jurczak A, Grochans E

机构信息

Department of Nursing, Faculty of Health Sciences, Pomeranian Medical University in Szczecin, Szczecin, Poland.

出版信息

Eur Rev Med Pharmacol Sci. 2023 Mar;27(6):2453-2468. doi: 10.26355/eurrev_202303_31779.

Abstract

OBJECTIVE

Menopause is an important transition period in a woman's reproductive life during which hormonal changes occur, resulting in an increased risk of cardiovascular disease and type 2 diabetes. In this study, we assessed the possibility of using surrogate measures of insulin resistance (IR) to predict the risk of insulin resistance in perimenopausal women.

PATIENTS AND METHODS

The study involved 252 perimenopausal women living in the West Pomeranian Voivodeship. The methods employed in this study were diagnostic survey based on the original questionnaire, anthropometric measurement, and laboratory tests performed to determine the levels of selected biochemical parameters.

RESULTS

In the entire study population, the highest area under the curve was found for the homeostasis model assessment-insulin resistance (HOMA-IR) and quantitative insulin sensitivity check index (QUICKI). Triglyceride-glucose index (TyG index) showed a higher diagnostic value as a distinction tool between prediabetes and diabetes in perimenopausal women than the other markers. HOMA-IR significantly positively correlated with fasting blood glucose (r = 0.72; p = 0.001), glycated hemoglobin (HbA1C, r = 0.74; p = 0.001), triglycerides (TG, r = 0.18; p < 0.005), and systolic blood pressure (SBP, r = 0.15; p= 0.021), and negatively with high-density lipoprotein (HDL, r = -0.28; p = 0.001). QUICKI negatively correlated with fasting blood (r = -0.051; p = 0.001), HbA1C (r = -0.51; p = 0.001), TG (r = -0.25; p = 0.001), low-density lipoprotein (LDL, r = -0.13; p= 0.045), and SBP (r = -0.16; p = 0.011), and positively with HDL (r = 0.39; p = 0.001).

CONCLUSIONS

Anthropometric and cardiometabolic parameters were found to significantly correlate with IR markers. HOMA-beta, the McAuley index (McA), visceral adiposity index (VAI), and lipid accumulation product (LAP) may be useful as predictors of pre-diabetes and diabetes in postmenopausal women.

摘要

目的

绝经是女性生殖生活中的一个重要过渡时期,在此期间会发生激素变化,导致心血管疾病和2型糖尿病的风险增加。在本研究中,我们评估了使用胰岛素抵抗(IR)替代指标预测围绝经期女性胰岛素抵抗风险的可能性。

患者与方法

该研究纳入了252名居住在西波美拉尼亚省的围绝经期女性。本研究采用的方法包括基于原始问卷的诊断性调查、人体测量以及为测定选定生化参数水平而进行的实验室检查。

结果

在整个研究人群中,稳态模型评估-胰岛素抵抗(HOMA-IR)和定量胰岛素敏感性检查指数(QUICKI)的曲线下面积最高。甘油三酯-葡萄糖指数(TyG指数)作为围绝经期女性糖尿病前期和糖尿病的鉴别工具,其诊断价值高于其他指标。HOMA-IR与空腹血糖(r = 0.72;p = 0.001)、糖化血红蛋白(HbA1C,r = 0.74;p = 0.001)、甘油三酯(TG,r = 0.18;p < 0.005)和收缩压(SBP,r = 0.15;p = 0.021)显著正相关,与高密度脂蛋白(HDL,r = -0.28;p = 0.001)显著负相关。QUICKI与空腹血糖(r = -0.051;p = 0.001)、HbA1C(r = -0.51;p = 0.001)、TG(r = -0.25;p = 0.001)、低密度脂蛋白(LDL,r = -0.13;p = 0.045)和SBP(r = -0.16;p = 0.011)显著负相关,与HDL(r = 0.39;p = 0.001)显著正相关。

结论

发现人体测量和心脏代谢参数与IR指标显著相关。HOMA-β、麦考利指数(McA)、内脏脂肪指数(VAI)和脂质蓄积产物(LAP)可能有助于预测绝经后女性的糖尿病前期和糖尿病。

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