论文部分内容阅读
目的探讨脑卒中患者胰岛素抵抗(IR)与血清游离脂肪酸(FFA)的关系。方法选取2012年1月至2014年1月神经内科收治的115例脑卒中患者为研究对象,根据CT诊断病灶范围将患者分为大梗死灶组38例,中梗死灶组40例,小梗死灶组37例。另选取110例无脑卒中病史的正常健康体检者为对照组,测定两组血清FFA、空腹血糖(FBG)、糖化血红蛋白(Hb A1c)、空腹胰岛素(FINS)、三酰甘油(TG)、总胆固醇(TC)、低密度脂蛋白(LDLC)、高密度脂蛋白(HDL-C)、载脂蛋白B(APOB)、载脂蛋白A1(APOA1),并计算各组体质指数(BMI)及胰岛素抵抗指数(HOMA-IR)。采用Pearson直线相关进行影响IR的单因素分析,采用Logistic多因素回归进行影响IR的多因素分析。结果脑卒中组患者血清FFA、FBG、Hb A1c、FINS、TG、TC、LDL-C、APOB、HOMA-IR水平显著高于对照组(P<0.05,P<0.01),而HDL-C、APOA1水平显著低于对照组(P均<0.01),差异有统计学意义。脑卒中患者中大梗死灶组血清FFA、FBG、Hb A1c、FINS、TG、TC、LDL-C、APOB、HOMA-IR水平高于中、小梗死灶组(P均<0.05),而APOA1、HDL-C水平显著低于中、小梗死灶组(P均<0.05)。经Pearson相关因素分析可知,血清FFA与FINS、FBG、Hb A1c、APOB、LDL-C、HOMA-IR呈正相关(P均<0.01),而与APOA1呈负相关(P<0.01),与TG、TC、HDL-C无相关性(P均>0.05)。经Logistic多因素回归分析可知,FFA、FBG、Hb A1c、LDL-C是HOMA-IR的独立危险因素。结论脑梗死患者存在IR状态及高FFA血症,FFA水平是脑卒中患者发生IR的独立危险因素。
Objective To investigate the relationship between insulin resistance (IR) and serum free fatty acid (FFA) in stroke patients. Methods From January 2012 to January 2014, 115 stroke patients admitted to Department of Neurology were enrolled in this study. According to the range of CT diagnosis, 38 patients were divided into large infarction group, 40 middle infarction group, Group of 37 cases. Another 110 normal healthy subjects without a history of stroke were selected as the control group. The levels of serum FFA, fasting blood glucose (FBG), Hb A1c, FINS, TG, Cholesterol (TC), low density lipoprotein (LDLC), high density lipoprotein (HDL-C), apolipoprotein B (APOB) and apolipoprotein A1 (APOA1) were measured. Body mass index (BMI) and insulin Resistance index (HOMA-IR). Univariate analysis using Pearson’s linear correlation to influence IR and multivariate analysis to influence IR with Logistic regression analysis. Results The levels of serum FFA, FBG, Hb A1c, FINS, TG, TC, LDL-C, APOB and HOMA-IR in the stroke group were significantly higher than those in the control group (P < The level was significantly lower than the control group (P <0.01), the difference was statistically significant. The levels of serum FFA, FBG, Hb A1c, FINS, TG, TC, LDL-C, APOB and HOMA-IR in patients with stroke were higher than those in the middle and small infarct groups (P <0.05) The level of HDL-C was significantly lower than that of middle and small infarction group (all P <0.05). Pearson correlation analysis revealed that serum FFA was positively correlated with FINS, FBG, Hb A1c, APOB, LDL-C, HOMA-IR (all P <0.01) TC, HDL-C no correlation (P> 0.05). Logistic regression analysis showed that FFA, FBG, Hb A1c and LDL-C were independent risk factors of HOMA-IR. Conclusions There is IR status and hyperfuncainemia in patients with cerebral infarction. FFA level is an independent risk factor for stroke in patients with stroke.