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男性 2 型糖尿病患者中高血压和血脂异常与胰岛素抵抗的关系。

Insulin Resistance in relation to Hypertension and Dyslipidaemia among Men Clinically Diagnosed with Type 2 Diabetes.

机构信息

Department of Medical Laboratory Science, University of Health and Allied Sciences, Ho, Ghana.

Department of Biomedical Laboratory Science, University for Development Studies, Tamale, Ghana.

出版信息

Biomed Res Int. 2023 May 26;2023:8873226. doi: 10.1155/2023/8873226. eCollection 2023.

Abstract

Pathophysiologically, type 2 diabetes can result from insulin resistance or insulin insufficiency alone. It is unclear whether relative insulin shortage or pronounced insulin resistance is linked to poor cardiometabolic problems like obesity. Therefore, the objective of this study was to evaluate the relationship between insulin resistance (IR), hypertension, and dyslipidaemia, in men with type 2 diabetes mellitus. One hundred and twenty-one (121) type 2 diabetic men participated in this cross-sectional study, which was conducted between September 2018 and September 2019. Sociodemographic information was collected using a self-designed questionnaire. Anthropometric data were also taken and blood samples collected for estimation of insulin, glucose, and lipid concentrations. HOMA-IR was calculated from the fasting insulin and glucose values, and a HOMA - IR ≥ 2 was considered to indicate insulin resistance. Of the 121 participants, 39.7% were classified as insulin-resistant. Levels of total cholesterol (4.82 ± 1.2 mmol/L; = 0.007 vs. 4.25 ± 1.1 mmol/L), LDL cholesterol (3.17 ± 0.9 mmol/L; = 0.001 vs. 2.52 ± 0.8 mmol/L), and TC/HDL-C ratio (3.93 ± 0.9; = 0.042 vs. 3.58 ± 0.9) and the prevalence of abnormal LDL-C (14.6%; = 0.015 vs. 2.7%) and elevated BP (83.3%; = 0.048 vs. 67.1%) were higher in the insulin-resistant group. LDL cholesterol (AUC = 0.670; = 0.001) better classified subjects as being insulin-resistant compared to other lipid markers. The odds of insulin resistance in dyslipidaemia were not statistically significant after adjusting for obesity. The link between insulin resistance and dyslipidaemia and hypertension in male diabetics may thus be mediated by obesity.

摘要

从病理生理学角度来看,2 型糖尿病可能仅由胰岛素抵抗或胰岛素不足引起。目前尚不清楚相对胰岛素缺乏或明显的胰岛素抵抗与肥胖等不良心血管代谢问题之间是否存在关联。因此,本研究旨在评估 2 型糖尿病男性患者的胰岛素抵抗(IR)、高血压和血脂异常之间的关系。本横断面研究于 2018 年 9 月至 2019 年 9 月期间招募了 121 名 2 型糖尿病男性患者,参与者填写了自设问卷以提供社会人口统计学信息,同时还进行了人体测量学数据采集和血样采集以评估胰岛素、血糖和血脂浓度。空腹胰岛素和血糖值用于计算 HOMA-IR,HOMA-IR≥2 被认为存在胰岛素抵抗。在 121 名参与者中,39.7%被归类为胰岛素抵抗。总胆固醇(4.82±1.2mmol/L; = 0.007 比 4.25±1.1mmol/L)、LDL 胆固醇(3.17±0.9mmol/L; = 0.001 比 2.52±0.8mmol/L)和 TC/HDL-C 比值(3.93±0.9; = 0.042 比 3.58±0.9)以及异常 LDL-C 的患病率(14.6%; = 0.015 比 2.7%)和升高的血压(83.3%; = 0.048 比 67.1%)在胰岛素抵抗组中更高。LDL 胆固醇(AUC=0.670; = 0.001)比其他血脂标志物更好地对受试者进行胰岛素抵抗分类。在调整肥胖后,血脂异常患者发生胰岛素抵抗的几率没有统计学意义。因此,男性糖尿病患者中胰岛素抵抗与血脂异常和高血压之间的联系可能是由肥胖介导的。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6ce1/10238133/b5aafd2943c1/BMRI2023-8873226.001.jpg

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