摘要
目的探讨稳态模型评估胰岛素抵抗指数(HOMA-IR)在肥胖患者中的特征及相关性分析。方法本研究为回顾性队列研究,选取2020年1月至2023年1月安徽医科大学第二附属医院普外科收治的1214例行腹腔镜袖状胃切除的患者,男272例,女942例,年龄(31.46±6.54)岁,年龄范围为18~50岁,收集并比较患者的临床资料,包括一般资料(性别、年龄、体质量指数)及生化指标(总胆固醇、甘油三酯、天冬氨酸转氨酶、丙氨酸转氨酶、尿酸、C肽、糖化血红蛋白、空腹胰岛素、空腹血糖),计算HOMA-IR。采用Spearman相关系数分析体质量指数、甘油三酯、糖化血红蛋白、HOMA-IR与各生化指标的相关性,采用多元线性回归模型对HOMA-IR的危险因素进行分析。结果男性患者体质量指数[(41.79±6.12)kg/m^(2)]、总胆固醇[(4.98±1.09)mmol/L]、甘油三酯[1.96(1.43,2.81)mmol/L]、天冬氨酸转氨酶[33.00(23.75,52.00)U/L]、丙氨酸转氨酶[59.00(37.75,96.25)U/L]、尿酸[(458.73±100.15)μmol/L]、C肽[(5.71±2.40)μg/L]、糖化血红蛋白[6.10(5.70,7.00)%]、空腹胰岛素[32.69(22.44,46.93)μU/ml]、HOMA-IR[8.43(5.53,12.66)]均高于女性[(38.05±5.90)kg/m^(2)、(4.76±0.92)mmol/L、1.53(1.12,2.16)mmol/L、25.00(17.00,41.00)U/L、35.00(20.00,64.00)U/L、(385.13±89.18)μmol/L、(4.58±2.09)μg/L、5.80(5.50,6.50)%、23.81(16.31,34.99)μU/ml、6.10(3.89,9.79)],差异有统计学意义(P<0.05)。体质量指数与天冬氨酸转氨酶、丙氨酸转氨酶、尿酸、C肽、糖化血红蛋白、空腹胰岛素、空腹血糖、HOMA-IR呈正相关,甘油三酯、HOMA-IR与各生化指标均呈正相关,差异有统计学意义(P<0.05)。高龄、高体质量指数、高甘油三酯和高糖化血红蛋白是HOMA-IR线性模型中的危险因素(P<0.05)。结论HOMA-IR适用肥胖患者的胰岛素抵抗评估,高龄、高体质量指数、高甘油三酯和高糖化血红蛋白是HOMA-IR的危险因素。
Objective To explore the characteristics and correlation analysis of the homeostatic model assessment for insulin resistance(HOMA-IR)in obese patients.Methods This study was a retrospective cohort study,a total of 1214 patients who underwent sleeve gastrectomy in the department of General Surgery in The Second Affiliated Hospital of Anhui Medical University from January 2020 to January 2023 were admitted,including 272 males and 942 females,aged(31.46±6.54)years old,ranging from 18 to 50 years old.Clinical data of patients were collected and compared,including general data(sex,age,body mass index)and biochemical indicators(total cholesterol,triglycerides,aspartate transaminase,alanine transaminase,uric acid,C peptide,glycated hemoglobin,fasting insulin,fasting blood glucose),calculate HOMA-IR.The correlation of body mass index,triglycerides,glycosylated hemoglobin,HOMA-IR and each biochemical index were analyzed by Spearman′s correlation coefficient,and the risk factors of HOMA-IR were analyzed by using a multiple linear regression model.Results Male patients with body mass index[(41.79±6.12)kg/m^(2)],total cholesterol[(4.98±1.09)mmol/L],triglycerides[1.96(1.43,2.81)mmol/L],aspartate transaminase[33.00(23.75,52.00)U/L],alanine transaminase[59.00(37.75,96.25)U/L],uric acid[(458.73±100.15)μmol/L],C peptide[(5.71±2.40)μg/L],glycated hemoglobin[6.10(5.70,7.00)%],fasting insulin[32.69(22.44,46.93)μU/ml],HOMA-IR[8.43(5.53,12.66)]were higher than female patients[(38.05±5.90)kg/m^(2),(4.76±0.92)mmol/L,1.53(1.12,2.16)mmol/L,25.00(17.00,41.00)U/L,35.00(20.00,64.00)U/L,(385.13±89.18)μmol/L,(4.58±2.09)μg/L,5.80(5.50,6.50)%,23.81(16.31,34.99)μU/ml,6.10(3.89,9.79)],the differences were statistically significant(P<0.05).Body mass index was positively correlated with aspartate transaminase,alanine aminotransferase,uric acid,C peptide,glycated hemoglobin,fasting insulin,fasting blood glucose and HOMA-IR,triglycerides and HOMA-IR were positively correlated with each biochemical index,the differences were statistica
作者
祖富强
龚鑫
汪贵
余亮
贾犇黎
Zu Fuqiang;Gong Xin;Wang Gui;Yu Liang;Jia Benli(Department of General Surgery,The Second Affiliated Hospital of Anhui Medical University,Hefei 230601,China)
出处
《中国临床实用医学》
2024年第4期18-22,共5页
China Clinical Practical Medicine
基金
安徽医科大学第二附属医院国家自然基金青年孵育计划(2023GQFY02)。
关键词
肥胖
糖代谢
胰岛素抵抗
稳态模型评估胰岛素抵抗指数
Obesity
Glucose metabolism
Insulin resistance
Homeostatic model assessment for insulin resistance
