·糖尿病与心脏病·

　　胰岛素抵抗状态下2型糖尿病患者不同水平糖化血红蛋白与心肌损伤指标间关系的观察

　　何雷 赵星辰 周斌 欧阳奋竞 尹瀚鹏 年碧霄 谭泽世 蔡德鸿

　　【摘要】 目的 探讨IR状态下T2DM患者不同水平HbA1c与肌酸激酶(CK)、肌酸激酶同工酶(CK-MB)与肌酸激酶比值、肌钙蛋白Ⅰ(TnⅠ)间的关系。方法 选取糖尿病患者168例，根据HbA1c水平分为3组，A组(HbA1c≤6.4%)56例，B组(7.1%0.05); A组HOMA-IR最低(2.96±3.57)，与B组(4.11±2.91)、C组(4.17±4.93)相比差异有统计学意义(P=0.0000)。结论 CK-MB/CK比值在3组中分别为(0.12±0.06)、(0.10±0.04)、(0.13±0.05)，按F/χ2得出P=0.004。但仅据A、B组间差异有统计学意义并不能立即判断CK-MB/CK比值越小，对心肌损害越少，仍需进一步研究证实。

　　【关键词】糖化血红蛋白;肌酸激酶;肌酸激酶同工酶; 肌钙蛋白Ⅰ;胰岛素抵抗指数

Significance of different levels of glycosylated hemoglobin and myocardial injury markers in insulin resistance HE Lei, ZHAO Xing-chen, ZHOU Bin, et al. Department of Endocrinology, Zhujiang Hospital, Southern Medical University, Guangzhou 510282, China

　　Corresponding author: CAI De-hong, E-mail: cai_de_hong@163.com

　　【Abstract】 Objective To study the relationship between different levels of glycosylated hemoglobin and myocardial injury indicators of T2DM patients in the state of insulin resistance. Methods A total of 168 subjects aged 55~65 years with T2DM were recruited. They were divided based on the level of glycosylated hemoglobin into three groups, Group A (HbA1c≤6.4%), Group B (7.1%0.05). HOMA-IR was statistically different among the three groups，which was the lowest in Group A (2.96±3.57), significantly different from that of Group B (4.11±2.91) and Group C(4.17±4.93), P=0.000. Conclusion The CK-MB/CK of the three groups was (0.12 ± 0.06), (0.10 ± 0.04), and (0.13 ± 0.05) respectively, and according to F/χ2 it obtained P=0.004. Between Groups B and C there is a significant difference in CK-MB/CK. But the conclusion made immediately that “the smaller the CK-MB/CK is, the less myocardial damage is” may be not scientific, and further studies on it are needed to confirm.

　　【Key words】 Glycosylated hemoglobin (HbA1c); Creatine kinase (CK); Creatine kinase isoenztme MB (CK-MB); Troponin I (TnⅠ); Insulin resistance (IR)