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一、高胰岛素血症和冠状动脉硬化症1.流行病学对非糖尿病者研究表明,高胰岛素血症是冠状动脉硬化的重要易患因素。Standl等以NIDDM为对象和健康组进行对照研究表明,糖尿病患者发生动脉硬化症(CAD)占58%,对照组为38%合并动脉硬化,二组血浆中CPR均呈有意义高值。以胰岛素治疗合并动脉硬化性NIDDM时,胰岛素的使用量和空腹胰岛素浓度均为高值。2.临床研究结果取血脂阳性男性和临界型糖耐量正常者做选择性冠状动脉造影。通过冠状动脉病变,研究内源性胰岛素分泌和CAD的关系。对象是65名血脂阳性男性,至少有一支主要冠状动脉为有意义狭窄的CAD组和正常冠状动脉组(NCA)。给予75克葡萄糖进行OGTT,测负荷前、负荷后30、60、120分钟血糖值,并计算IRI总和(ΣBG、ΣIRI)和服糖前30或60分钟差值(ΔBG_(30)、ΔBG_(60)、ΔIRL_(30)、ΔIRI_(60))。比较结果,两组糖耐量无差异,但CAD组ΣIRI、ΔIRI呈有意义高值。对高胰岛素血症临界型糖耐量正常者41名进行同样研究,CAD组ΣIRI、ΣIRI/ΣBG、ΔIRI_(30)、ΔIRI_(60)和ΔIRI_(30)/ΔBG_(30)呈有意义高值。Ge-
First, hyperinsulinemia and coronary atherosclerosis 1. Epidemiology Non-diabetic studies have shown that hyperinsulinemia is an important predisposition to coronary artery disease. Standl and NIDDM for the control group and healthy subjects control study showed that diabetic patients with atherosclerosis (CAD) accounted for 58% of the control group was 38% with atherosclerosis, plasma CPR in both groups showed significant high. Insulin treatment combined with atherosclerosis NIDDM, the use of insulin and fasting insulin concentrations are high. 2.Clinical research results take blood lipid-positive men and critical glucose tolerance of patients with selective coronary angiography. Through coronary artery disease, the relationship between endogenous insulin secretion and CAD was studied. The subjects were 65 lipid-positive men and at least one of the major coronary arteries was a clinically meaningful CAD group and a normal coronary artery group (NCA). The blood glucose levels of 30, 60, 120 minutes before and after the load were measured by OGTT, and the difference between the total IRI (ΣBG, ΣIRI) and 30 or 60 minutes before the administration of sugar (ΔBG_ (30), ΔBG_ (60) , ΔIRL_ (30), ΔIRI_ (60)). Comparing the results, there was no difference in the two groups of glucose tolerance, but the ΣIRI and ΔIRI in the CAD group showed significant high value. In the same study of 41 subjects with normal hyperinsulinemia and normal glucose tolerance, the values of ΣIRI, ΣIRI / ΣBG, ΔIRI_ (30), ΔIRI_ (60) and ΔIRI_ (30) / ΔBG_ (30) in CAD group were significant. Ge-