胰岛素抵抗与凝血指标和血小板参数的相关性分析

doi:10.3969/j.issn.1006-7795.2013.01.028

摘要/Abstract

摘要：

目的研究胰岛素抵抗(insulin resistance, IR)与凝血指标和血小板参数之间的相关性。方法研究对象为新发2型糖尿病(type 2 diabetes mellitus,DM)和非糖尿病(non-diabetes mellitus,NDM)患者,分别为392例和95例。根据IR程度按四分位分成4组,由低到高依次为A、B、C和D组。比较各亚组DM和NDM患者各项凝血指标和血小板参数的差异。结果 DM与NDM亚组在不同IR水平凝血酶原时间(prothrombin time, PT)、部分凝血活酶时间(activated partial prothrombin time,APTT)、血小板平均体积(mean platelet volume,MPV)、大血小板比率(platelet-large cell ratio,P-LCR)和高密度脂蛋白胆固醇(high density lipoprotein cholesterol, HDL-C)的差异有统计学意义。A、B、C和D组中在DM、NDM亚组间PT差异有统计学意义。IR水平和是否合并DM在PT、APTT、PDW、MPV和P-LCR水平存在交互作用。结论 IR可作为独立的影响因素作用于凝血过程的环节中,IR患者存在体内高凝状态及出现血栓性疾病的倾向。

关键词: 2型糖尿病, 胰岛素抵抗, 稳态模式评估法

Abstract:

Objective To investigate the relationship between insulin resistance(IR)and coagulation indices and platelet parameters in patients with or without type 2 diabetes mellitus (DM). Methods Totally 392 patients with new onset DM and 95 patients with non-diabetes mellitus (NDM) were enrolled. The patients were assigned into four groups (A, B, C and D group) based on the quartile of IR to compare coagulation indices and platelet parameters among the subgroups. Results Significant difference in prothrombin time(PT), activated partial prothrombin time(APTT), platelet distribution width(PDW), mean platelet volume(MPV), platelet-large cell ratio(P-LCR) and low-density lipoprotein cholesterol(LDL-C ) with the level of IR were found among the four subgroups in DM and NDM patients. Also, PT among the four subgroups have significant difference between DM and NDM patients. Interactions were found in coagulation indices (PT and APTT), platelet parameters (PDW, MPV and P-LCR) between the level of IR and whether the patients had DM or not. Conclusion IR could be an independent factor to act on the process of the coagulation of blood. The patients with IR predisposed to present hyper-coagulation state and underlying thrombotic disease.

Key words: type 2 diabetes mellitus, insulin resistance, homeostasis model assessment

中图分类号:

R587.1

杨宁, 王立, 徐援, 张冬磊. 胰岛素抵抗与凝血指标和血小板参数的相关性分析[J]. 首都医科大学学报, 2013, 34(1): 144-149.

YANG Ning, WANG Li, XÜ Yuan, ZHANG Donglei. Relationship between insulin resistance and coagulation indices and platelet parameters in patients with type 2 diabetes mellitus[J]. Journal of Capital Medical University, 2013, 34(1): 144-149.

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