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目的探讨多重心血管危险因素综合干预与胰岛素抵抗的关系。方法276例高血压或(和)糖尿病患者,依据HO-MA-IR指数分为胰岛素抵抗(IR)组和胰岛素敏感(IS)组,观察综合干预前后两组患者相关指标达标情况。结果(1)腹围、空腹血糖与HOMA指数的相关性最明显(P<0.01),干预前后IR组患者空腹血糖、女性腹围达标率均显著低于IS组。(2)干预前IR组达标项数≥3项的达标率显著低于IS组(26.6%vs 43.5%,P<0.01),干预后两组比较无统计学意义;干预前、后IR组达标项≥4项的达标率均显著低于IS组(9.7%vs 19.6%,P<0.05;12.4%vs 27.6%,P<0.01)。结论胰岛素抵抗与腹围和空腹血糖密切相关,胰岛素抵抗更容易合并多重心血管危险因素,并影响心血管危险因素的治疗达标率。
Objective To explore the relationship between multiple cardiovascular risk factors and insulin resistance. Methods 276 patients with hypertension or (or) diabetes were divided into insulin resistance (IR) group and insulin sensitive (IS) group according to HO-MA-IR index to observe the compliance of relevant indicators before and after the comprehensive intervention. Results (1) The correlation between abdominal circumference and fasting blood glucose and HOMA index was the most significant (P <0.01). The fasting blood glucose and the abdominal compliance rate of women in IR group before and after intervention were significantly lower than those in IS group. (2) Before the intervention, the compliance rate of ≥3 items in IR group was significantly lower than that in IS group (26.6% vs 43.5%, P <0.01). There was no significant difference between the two groups after intervention The compliance rate of ≥4 items was significantly lower than IS group (9.7% vs 19.6%, P <0.05; 12.4% vs 27.6%, P <0.01). Conclusion Insulin resistance is closely related to abdominal circumference and fasting blood glucose, insulin resistance is more likely to combine multiple cardiovascular risk factors and affect the compliance rate of cardiovascular risk factors.