The Clinical Research On Relationship Between Insulin Resistance In Patient With Type2Diabetes Mellitus And Carotid Intima-media Thickness

Thickness Insulin resistance (IR) and hyperinsulinemia (HIS) is the basis of type2diabetes and a major source of metabolic syndrome and other diseases.IR is the originalmotivation and pathogenic basis of a large number of cardiovascular diseases and metabolicdiseases,is the central link of many common metabolic disease.Carotid intima-mediathickness can be used to reflect the individual load of atherosclerosis extent,It is a powerfulfactor that can be used to predict cardiovascular and cerebrovascular diseases.Objective：In this article,the carotid intima-media thickness,an early indicator as aresponse of atherosclerosis,is observed that the changes and correlation in the type2diabetesand the correlations with the other metabolic indexes.And CIMT,glucose,lipids,insulin levelswere measured and statistically analyzed through the insulin resistance group andnon-insulin resistance group to explore the the relationship between AS and insulinresistance in patients with type2diabetes.Materials and methods:(1)Subjects:Choose T2DM patients in the endocrinologydepartment of our hospital from June2010to September2011as the research objects.Allselected patients were checked the color Doppler ultrasonography in the examination roomof our hospital.The subjects into two groups according to CIMT=0.9mm:the group ofCIMT≧0.9mm have93patients,male52;female41,average age（57.5±7.3）year;The groupof CIMT<0.9mm have71patients,male41;female30.Average age（52.6±6）year.(2)Criteriaof diagnosis:①Diagnosis of DM according to the standard China Diabetes Guide in2007.②Diagnosis of EH according to the new diagnostic criteria of WHO in1999.③E xclusion criteria:Suffering from liver and kidney dysfunction;Patients with variousacute and chronic diseases; Various cancer patients;Other endocrine diseases patients andTaking hormone for a long-term.(4) Clinical data: the patients into the group allMeasured:Age、FPG、F-Ins、2hPG、HbA1c、BMI、TG、TC、HDL-C、LDL-C、SBP、DBP、60min、120min、180min PBG and Ins.(5)All the data were carried out using SPSS17.0statistical software.Expressed by the parameters X±S,Taken TC、TG、HDL-c to thenatural logarithm so that it becomes a normal distribution after then to statistical.Use theCarotid intima-media thickness as the dependent variable,the relevant index as independent variables to the Logistic regression analysis.Results:Comparison between the two groups:(1) FBG、2hPG、F-Ins、TG、LDL-c、HOMA-IR、 BMI,there are significant differences between the CIMT＜9mm andCIMT≧9mm two groups.(2) F-Ins、2hPG、HOMA-IR、IMT, there are significant differencesbetween the IR and NIR two groups.Blood glucose, insulin detection in Sub-groups0,60,120,180min,display IR group is high blood sugar,high insulin state,while the insulinlevel in IR group were higher than that of NIR group,there are significant differencesbetween the IR and NIR two groups.(3)we use the Carotid intima-media thickness as thedependent variable,the relevant index as independent variables to the multiple stepwiseregression analysis:BMI、2hPG、HOMA-IR,into the statistical equation respectively.From theabove statistical analysis,we can be concluded:BMI、2hPG、HOMA-IR as an independentrisk factor of carotid CAS.Conclusion:(1)In type2diabetes,high blood sugar,hyperinsulinemia,dyslipidemia,insulin resistance and other factors will affect the carotid artery thickness changes.(2)Carotid ultrasonography is a quick,easy and safe non-invasive screening method for patientswith type2diabetes on atherosclerosis,which is a early screening and monitoring tools.(3)Early detection,early diagnosis and intervention through daily life or drug treatment,canpredict and prevent of major vascular complications of type2diabetes,and defer thedevelopment of complications.