Department of Biochemistry, Military Hospital 103, Vietnam Military Medical University Hanoi, Vietnam.
Laboratory Animal Research Center, Vietnam Military Medical University, Hanoi, Vietnam.
Medicine (Baltimore). 2024 Nov 1;103(44):e40212. doi: 10.1097/MD.0000000000040212.
This study aims to evaluate impaired insulin tolerance among Vietnamese diabetes with or without dyslipidemia. Diabetes mellitus (DM) remains the serious global health and social burden that has increased over the past few decades. It progresses silently to vascular injury and disability of injured vascular-perfused tissues/organs. Insulin intolerance and dyslipidemia exacerbate and accelerate the implications of DM. Thus, early detection and more evidence of early insulin intolerance and dyslipidemia is needed for proactive management. This cross-sectional descriptive study recruited 100 healthy control (HC) and 297 DM patients in Military Hospital 103 from 2021 to 2023. Patients with DM were subgrouped into lipid metabolism disorder (LMD, n = 98) and non-LMD (NLMD, n = 99). The biochemists' serum levels were measured automatically and the accuracy of the test result was strictly controlled. Insulin tolerance indices (HOMA2-IR, HOMA2-%S and HOMA2-%B) were compared between HC, DM with or without dyslipidemia as well as correlated with lipid ingredients (total Cholesterol, triglyceride, LDL-C and HDL-C). Among DM patients, HOMA2-IR was significantly high and HOMA2-%S and HOMA2-%B were significantly low. HOMA2-IR was higher and HOMA2-%S and HOMA2-%B were lower in DM with LMD than in DM without LMD. In addition, HOMA2-IR was positively correlated with serum cholesterol, triglyceride and LDL-C concentration, and negatively correlated to HDL-C concentration. In contrast, HOMA2-%S and HOMA2-%B was negatively correlated with serum cholesterol, triglyceride and LDL-C, and positively correlated with HDL-C. Impaired insulin intolerance occurred in early stage of DM, and more serious among DM with LMD, compared to DM with NLMD.
本研究旨在评估越南糖尿病患者伴或不伴血脂异常的胰岛素抵抗情况。糖尿病（DM）仍然是一个严重的全球健康和社会负担，在过去几十年中有所增加。它会悄无声息地进展为血管损伤，并导致受血管灌注组织/器官的功能障碍。胰岛素抵抗和血脂异常会加重和加速 DM 的影响。因此，需要早期检测和更多证据来早期发现胰岛素抵抗和血脂异常，以便进行主动管理。本横断面描述性研究于 2021 年至 2023 年在第 103 军医院招募了 100 名健康对照（HC）和 297 名 DM 患者。将 DM 患者分为脂质代谢紊乱（LMD，n=98）和非-LMD（NLMD，n=99）。自动测量生化血清水平，严格控制检测结果的准确性。比较 HC、伴或不伴血脂异常的 DM 患者以及与血脂成分（总胆固醇、甘油三酯、LDL-C 和 HDL-C）之间的胰岛素耐量指数（HOMA2-IR、HOMA2-%S 和 HOMA2-%B）。在 DM 患者中，HOMA2-IR 显著升高，HOMA2-%S 和 HOMA2-%B 显著降低。与 NLMD 相比，LMD 组的 HOMA2-IR 更高，HOMA2-%S 和 HOMA2-%B 更低。此外，HOMA2-IR 与血清胆固醇、甘油三酯和 LDL-C 浓度呈正相关，与 HDL-C 浓度呈负相关。相反，HOMA2-%S 和 HOMA2-%B 与血清胆固醇、甘油三酯和 LDL-C 呈负相关，与 HDL-C 呈正相关。胰岛素抵抗在 DM 的早期阶段发生，在伴 LMD 的 DM 中更为严重，与不伴 NLMD 的 DM 相比。
