[1]杨丽红,周欢欢,孔维敏,等.胰岛素抵抗住院患者颈动脉斑块相关危险因素分析[J].陕西医学杂志,2019,(1):35-38.
　YANG Lihong,ZHOU Huanhuan,KONG Weimin,et al.Carotid artery plaque and its predictive factors among inpatients with insulin resistance[J].,2019,(1):35-38.
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胰岛素抵抗住院患者颈动脉斑块相关危险因素分析
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《陕西医学杂志》[ISSN:1000-7377/CN:61-1281/TN]

卷:
期数:
2019年1期
页码:
35-38
栏目:
临床研究
出版日期:
2019-01-05

文章信息/Info

Title:
Carotid artery plaque and its predictive factors among inpatients with insulin resistance
文章编号:
DOI:10.3969/j.issn.10007377.2019.01.011
作者:
杨丽红1; 周欢欢2; 孔维敏3; 沈建平1; 支 灏1; 徐书杭1; 楼青青1
1.南京中医药大学附属中西医结合医院健康教育科、心血管内科、内分泌代谢病区（南京210028）；2.江苏省常州市第一人民医院心胸外科（常州213003）；3.江苏省盐城市第一人民医院心内科（盐城224001）〖HJ1〗〖HJ〗
Author(s):
YANG Lihong; ZHOU Huanhuan; KONG Weimin; et al.
Affiliated Hospital of Integrated Traditional Chinese and Western Medicine,Nanjing University of Chinese Medicine（Nanjing 210028）
关键词:
胰岛素抵抗; 胰岛素抵抗指数; 颈动脉斑块; 危险因素; 相关分析
Keywords:
Key words Insulin resistance; HOMAIR; Carotid artery plaque; Predictive factors; Correlation analysis
分类号:
R587
文献标志码:
A
摘要:
摘 要 目的：探讨胰岛素抵抗(IR)住院患者对颈动脉斑块的影响。 方法 ：选取住院患者240例，按胰岛素抵抗指数(HOMAIR) 分成2组，无IR组和IR组。按颈动脉中是否有斑块分为有斑块组与无斑块组。分析IR与住院患者颈动脉斑块的关系。结果： 240例患者中，110例(45.8%)存在IR，144例(60.0%)有颈动脉斑块，IR组颈动脉斑块发生率是67.3%高于无IR组的53.8%，其中，IR人群发生颈动脉斑块是无IR人群的1.960倍( 95%CI,1.1193.431,P＜0.05)。年龄 (OR,1.045,95%CI,1.0111.079,P＜0.01)和LDLC (OR,1.549,95%CI,1.0042.390,P＜0.05)是无IR人群颈动脉斑块的独立危险因素，而IR人群颈动脉斑块的独立危险因素除了年龄(OR,1.073,95%CI,1.0271.121,P＜0.01)和HDLC(OR,0.178,95%CI,0.0350.897,P＜0.05 )之外，还包括HOMAIR (OR,1.732,95%CI,1.1312.651,P＜0.05)。结论： IR住院患者颈动脉斑块发生率高。IR是颈动脉斑块形成的独立危险因素。除了年龄和高血脂，HOMAIR也参与了住院患者颈动脉斑块的形成。IR的筛查可作为预防颈动脉斑块的指标。
Abstract:
Abstract Objective：To investigate the correlation between insulin resistance (IR) and carotid artery plaque in inpatients and its predictive factors. Methods：240 inpatients were divided into no IR group and IR group by homeostasis model assessment of insulin resistance (HOMAIR). And according to whether with carotid artery plaque or not,patients were separated into plaque group and no plaque group. Aims to analysis the relationship between IR and the predictive factors of plaque in inpatients. Results：Among 240 patients,there were 110 with IR,and 144 with carotid artery plaque,accounting for 48.5 and 60.0 percent,respectively. The prevalence of plaque in IR group was 67.3 percent,higher than no IR group whose prevalence was 53.8 percent. The incident carotid artery plaque events in patients with IR were 1.960 ( 95%CI,1.1193.431,P＜0.05) times higher than those without IR. Age(OR,1.045,95%CI,1.0111.079,P＜0.01) and LDLC (OR,1.549,95%CI,1.0042.390,P＜0.05)were significant predictive factors for no IR subjects. Age (OR,1.073,95%CI,1.0271.121,P＜0.01) and HDLC (OR,0.178,95%CI,0.0350.897,P＜0.05 ) were significantly associated with the formation of plaque in IR group. Apart from age and HDLC,HOMAIR played an important role in IR group with plaque. Conclusions：The prevalence of plaque in insulin resistance inpatients was high. IR was an important factor for inpatients with carotid artery plaque. Age,HOMAIR and different glycemic status were independent risk factors for insulin resistance inpatients. Except age and high plasma lipid,HOMAIR was an independent predictor of plaque. IR can be used as a screening standard for the prevention of carotid artery plaque.

参考文献/References:

[1] 陈伟伟,高润霖,刘力生,等. 中国心血管病报告2013概要 [J]. 中国循环杂志,2014,7：487491. [2] Fang FS,Liu MY,Cheng XL,et al. Insulin Resistance Correlates with the Arterial Stiffness before Glucose Intolerance [J]. Intern Med,2014,53：189194. [3] Prisant LM,Zemel PC,Nichols FT,et al. Carotid plaque associations among hypertensive patients [J]. Arch Intern Med,1993,153(4):501506. [4] Sourij H,Schmoelzer I,Dittrich P,et al. Insulin resistance as a risk factor for carotid atherosclerosis：a comparison of the Homeostasis Model Assessment and the short insulin tolerance test[J]. Stroke,2008,39(4):13491351. [5] Park YM,Han SH,Seo JG,et al. The role of insulin resistance and metabolic risk factors on culprit coronary plaque [J]. Int J Cardiol,2015,190:5662. [6] 李东辉,王韵红.胰岛素抵抗研究进展 [J]. 陕西医学杂志,2001,30（2）：9194. [7] 王晓明.TNFα、胰岛素抵抗与冠心病 [J]. 陕西医学杂志,2004,33（3）：248250. [8] 吕亚亚,师维雅,左玉琼,等. 2型糖病Toll样受体4与颈动脉内膜中层厚度的相关性研究[J]. 中华内分泌代谢杂志,2015,31(12)：10171021. [9] Mancia G,De Backer G,Dominiczak A,et al. 2007 guidelines for the management of arterial hypertension：The task force for the management of arterial hypertension of the european society of hypertension (esh) and of the european society of cardiology (esc) [J]. J Hypertens,2007,25 (6) ：11051187. 〖ZK）〗 [10] Plichart M,Celermajer DS,Zureik M,et al. Carotid intimamedia thickness in plaquefree site,carotid plaques and coronary heart disease risk prediction in older adults. The ThreeCity Study [J]. Atherosclerosis,2011,219(2):917924. [11] Sourij H,Schmoelzer I,Dittrich P,et al. Insulin resistance as a risk factor for carotid atherosclerosis：a comparison of the Homeostasis Model Assessment and the short insulin tolerance test [J]. Stroke,2008,39(4):13491351. [12] Ho CT,Lin CC,Hsu HS,et al. Arterial stiffness is strongly associated with insulin resistance in Chinesea populationbased study (Taichung Community Health Study,TCHS) [J]. J Atheroscler Thromb,2011,18(2):122130. [13] Ishizaka N,Ishizaka Y,Takahashi E,et al. Association between insulin resistance and carotid arteriosclerosis in subjects with normal fasting glucose and normal glucose tolerance [J]. Arterioscler Thromb Vasc Biol,2003,23(2):295301. [14] Negi SI,Nambi V. The role of carotid intimal thickness and plaque imaging in risk stratification for coronary heart disease [J]. Curr Atheroscler Rep,2012,14(2):115123. [15] PrlM,Miettinen H,Halonen P,et al. Insulin resistance syndrome predicts the risk of coronary heart disease and stroke in healthy middleaged men：the 22year followup results of the Helsinki Policemen Study [J]. Arterioscler Thromb Vasc Biol,2000,20(2):538544. [16] Park JS,Cho MH,Ahn CW,et al. The association of insulin resistance and carotid atherosclerosis with thigh and calf circumference in patients with type 2 diabetes [J]. Cardiovasc Diabeto,2012,19（11）:62. [17] Xu Y,Bi Y,Li M,et al. Significant coronary stenosis in asymptomatic Chinese with different glycemic status [J]. Diabetes Care,2013,36(6):16871694. [18] 王静懿,陶 枫.灵芪参口服液改善受体后胰岛素抵抗的研究进展[J].陕西中医,2017,38(11):16231624.

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更新日期/Last Update: 2019-01-22