胰岛素抵抗与 2 型糖尿病患者微血管和大血管并发症、死亡率及其他因素的关系:病例对照研究

Čypaitė Gabrielė, Šimonienė Diana, Rudminaitė Emilė
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摘要

摘要:目前缺乏对严重胰岛素抵抗(SIR)形式的分析研究,特别是从临床方面。本研究的主要目的是评估微血管和大血管并发症与 SIR 患者死亡率之间的关系。研究方法这是对 120 名 T2DM 患者进行的部分前瞻性病例对照研究。胰岛素剂量大于1 IU/kg/天的患者被视为SIR(病例组),胰岛素需求量小于1 IU/kg/天的患者为对照组。进行了统计分析。结果显示在微血管并发症方面,发现病例组与对照组相比,胰岛素剂量与糖尿病肾病(DN)发病率之间存在关联(138 与 170 IU/天),P = 0.002。患有 T2DM 和 SIR 的男性比女性更容易发生心肌梗死(39.3% 对 13.3%);P = 0.036。eGDR 较低(2.44 对 1.35)(或胰岛素抵抗较高)的病例组受试者更容易中风,p = 0.003。病例组男性比女性更有可能接受冠状动脉旁路移植手术(21.4% 对 3.3%);p = 0.048。病例组中 eGDR 较低的患者死亡率较高(1.01 对 1.85);p = 0.031。结论:在微血管结果方面,对照组和病例组的 DP 和 DR 发生率相似。只有病例组的 DN 发生率与较高的胰岛素剂量有关。中风、心肌梗死和搭桥手术等大血管并发症与男性性别和 SIR 有关,根据 eGDR,死亡率也较高。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Relationship of insulin resistance with microvascular and macrovascular complications, death rate and other factors in patients with type 2 diabetes: A case-control study
Abstract: There is a lack of studies analyzing Severe Insulin Resistance (SIR) forms, especially from clinical aspects. The main objective of this research was to assess the relationship between micro- and macrovascular complications and the death rate of patients with SIR. Methods: It was a partially prospective case-control study of 120 participants with T2DM. Patients with doses of insulin >1 IU/kg/day were considered to have SIR (case group), with an insulin requirement of <1 IU/kg/day - control group. Statistical analyses were performed. Results: Regarding microvascular complications, an association was found between insulin doses and the rate of Diabetic Nephropathy (DN) in the case group compared with the control group (138 vs. 170 IU/day), p = 0.002. Men with T2DM and SIR were more likely to present with myocardial infarction than women (39.3% vs. 13.3%); p = 0.036. Subjects of the case group with lower eGDR (2.44 vs. 1.35) (or higher insulin resistance) were more likely to suffer a stroke, p = 0.003. Case group males were more likely than females to undergo coronary artery bypass graft surgery (21.4% vs. 3.3%); p = 0.048. Higher mortality was observed in the case group of patients with lower eGDR (1.01 vs. 1.85); p = 0.031. Conclusion: As for microvascular outcomes, the rate of DP and DR was similar in both control and case groups. Only the rate of DN in the case group was associated with higher insulin doses. Macrovascular complications such as stroke, myocardial infarction, and bypass surgery were related to the male gender and SIR, as well as higher mortality according to eGDR.
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