胰岛素抵抗对葡萄糖耐量受损患者冠状动脉侧支循环的影响
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摘要
目的了解胰岛素抵抗对葡萄糖耐量(GT)受损患者冠状动脉侧支循环(CCC)的影响。方法 90例GT受损者及50例GT正常者作冠状动脉造影,用Rentrop法评价CCC情况,Logistic回归分析冠状动脉狭窄(CAS)或CCC与血糖、糖化血红蛋白、胰岛素抵抗指数相关性。结果 Logistic回归分析显示血糖、糖化血红蛋白、胰岛素抵抗指数与CCC呈负相关,但与CAS呈正相关;空腹胰岛素与CCC呈正相关,但与CAS呈负相关(均P<0.01)。结论 GT受损患者胰岛素抵抗可能促进CAS并影响CCC形成。
Objective To study the effect of insulin resistance(IR) on coronary collateral circulation(CCC) in patients with impaired glucose tolerance(GT). MethodsNinety patients with impaired GT and 50 subjects with normal GT underwent coronary angiography. CCC was evaluated using Rentrop classification. The correlations between coronary artery stenosis(CAS) or CCC and blood glucose, glycosylated hemoglobin and IR were assessed by Logistic regression analysis. Results Logistic regression analysis showed that blood glucose, glycosylated hemoglobin and IR were negatively correlated with CCC but positively with CAS, while fasting insulin was positively related to CCC but negatively to CAS. Conclusion IR might enhance CAS but reduce CCC in patients with impaired GT.
Objective To study the effect of insulin resistance(IR) on coronary collateral circulation(CCC) in patients with impaired glucose tolerance(GT). MethodsNinety patients with impaired GT and 50 subjects with normal GT underwent coronary angiography. CCC was evaluated using Rentrop classification. The correlations between coronary artery stenosis(CAS) or CCC and blood glucose, glycosylated hemoglobin and IR were assessed by Logistic regression analysis. Results Logistic regression analysis showed that blood glucose, glycosylated hemoglobin and IR were negatively correlated with CCC but positively with CAS, while fasting insulin was positively related to CCC but negatively to CAS. Conclusion IR might enhance CAS but reduce CCC in patients with impaired GT.
引文
[1]常学伟,张守彦,马惠芳,等.冠心病并糖耐量受损患者胰岛素抵抗与冠状动脉病变程度的相关性研究[J].中国动脉硬化杂志,2017,25(1):48-52.
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[4]李慧,李超民,刘薇,等.冠状动脉临界病变与胰岛素抵抗的关系[J].岭南心血管病杂志,2014,20(3):271-274.
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[9]张旭,吕豪,孙振学,等.非糖尿病患者胰岛素抵抗和炎症因子水平与冠状动脉病变严重程度相关性研究[J].中国医药,2012,07(6):665-667.
[10]范例,许左隽,顾俊,等.冠状动脉慢性闭塞患者侧支循环形成的影响因素分析[J].中国介入心脏病学杂志,2016,24(1):2-6.
[11]安宣齐.胰岛素抵抗对冠状动脉病变进展的影响[D].上海交通大学,2012.
[12]叶子青,吴天凤,乔松,等.胰岛素抵抗对非糖尿病患者冠状动脉病变的影响[J].中国现代医生,2012,50(17):66-69.
[13]Kashiwagi Y,Harada E,Mizuno Y,et al.Coronary spastic angina is associated with insulin resistance-possible involvement of endothelial dysfunction[J].Coron Artery Dis,2013,24(7):559-565.
[14]张建,汤全,刘达兴,等.体外循环缺血再灌注后心肌缺血胰岛素抵抗与相关因子变化关系的研究[J].心肺血管病杂志,2014,33(4):562-565.
[15]陈镇涛,王苓.吡格列酮联合二甲双胍对2型糖尿病患者胰岛素抵抗及炎性因子的影响[J].广东医科大学学报,2018,36(2):138-140.
[2]Klein O L,Okwuosa T,Chan C,et al.Changes in procoagulants track longitudinally with insulin resistance:findings from the coronary artery risk development in young adults(CARDIA)study[J].Diabet Med,2014,31(4):462-465.
[3]常学伟,张守彦,马惠芳,等.胰岛素抵抗与冠状动脉侧枝循环的相关性研究[C]//第二十四届长城国际心脏病学会议、亚太心脏大会暨国际心血管病预防与康复会议,2013:79.
[4]李慧,李超民,刘薇,等.冠状动脉临界病变与胰岛素抵抗的关系[J].岭南心血管病杂志,2014,20(3):271-274.
[5]唐振旺,陈仲,彭喜意,等.胰岛素敏(下转第496页)感性与冠状动脉扩张病变的相关性分析[J].重庆医学,2016,45(14):1912-1914.
[6]李韶南,罗义,李广镰,等.胰岛素抵抗、血压变异性与急性冠状动脉综合征的关系[J].中华内科杂志,2012,51(8):609-612.
[7]Kitta Y,Nakamura T,Uematsu M,et al.Insulin resistance negatively affects long-term outcome in non-diabetic patients with coronary artery disease after therapies to reduce atherosclerotic risk factors[J].J Cardiol,2013,62(6):348-353.
[8]董爱荣.冠心病患者病变冠状动脉支数与胰岛素抵抗的关系[J].实用心脑肺血管病杂志,2012,20(9):1452-1454.
[9]张旭,吕豪,孙振学,等.非糖尿病患者胰岛素抵抗和炎症因子水平与冠状动脉病变严重程度相关性研究[J].中国医药,2012,07(6):665-667.
[10]范例,许左隽,顾俊,等.冠状动脉慢性闭塞患者侧支循环形成的影响因素分析[J].中国介入心脏病学杂志,2016,24(1):2-6.
[11]安宣齐.胰岛素抵抗对冠状动脉病变进展的影响[D].上海交通大学,2012.
[12]叶子青,吴天凤,乔松,等.胰岛素抵抗对非糖尿病患者冠状动脉病变的影响[J].中国现代医生,2012,50(17):66-69.
[13]Kashiwagi Y,Harada E,Mizuno Y,et al.Coronary spastic angina is associated with insulin resistance-possible involvement of endothelial dysfunction[J].Coron Artery Dis,2013,24(7):559-565.
[14]张建,汤全,刘达兴,等.体外循环缺血再灌注后心肌缺血胰岛素抵抗与相关因子变化关系的研究[J].心肺血管病杂志,2014,33(4):562-565.
[15]陈镇涛,王苓.吡格列酮联合二甲双胍对2型糖尿病患者胰岛素抵抗及炎性因子的影响[J].广东医科大学学报,2018,36(2):138-140.