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武汉大学中南医院内分泌科 湖北 武汉 430071
Received:14 January 2024,
Published:25 April 2025
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聂钦,秦亚兰,李平等.血浆致动脉粥样硬化指数与2型糖尿病患者胰岛素抵抗的相关性分析[J].武汉大学学报(医学版),2025,46(04):524-531.
NIE Qin,QIN Yalan,LI Ping,et al.Correlation analysis between atherogenic index of plasma and insulin resistance in patients with type 2 diabetes[J].Medical Journal of Wuhan University,2025,46(04):524-531.
聂钦,秦亚兰,李平等.血浆致动脉粥样硬化指数与2型糖尿病患者胰岛素抵抗的相关性分析[J].武汉大学学报(医学版),2025,46(04):524-531. DOI: 10.14188/j.1671-8852.2024.0029.
NIE Qin,QIN Yalan,LI Ping,et al.Correlation analysis between atherogenic index of plasma and insulin resistance in patients with type 2 diabetes[J].Medical Journal of Wuhan University,2025,46(04):524-531. DOI: 10.14188/j.1671-8852.2024.0029.
目的
2
探究血浆致动脉粥样硬化指数(AIP)与2型糖尿病(T2DM)患者胰岛素抵抗(IR)的相关性。
方法
2
收集T2DM患者共1 089例。以HOMA⁃IR数值等于2为界限,分为非胰岛素抵抗组(N⁃IR)和胰岛素抵抗组(IR);根据纳入研究对象的AIP四分位数水平分为4组:Q
1
组、Q
2
组、Q
3
组、Q
4
组。
结果
2
(1)IR组中AIP高于N⁃IR组(
P
<
0.05)。(2)AIP分组中,随着AIP水平升高,HOMA⁃IR、IR患病率也随之升高(
P
<
0.05)。(3)Spearman相关性分析显示,AIP与HOMA⁃IR(
P
<
0.001)呈正相关。(4)在IR的多因素Logistic回归中,AIP的水平升高与IR风险升高相关,AIP每增加0.1个单位,IR概率增加22.9%,乳酸是IR危险因素,磷脂是IR的保护因素。(5)ROC曲线分析显示曲线下面积为0.702(95%
CI
:0.664~0.739)
最佳诊断阈值:0.080 5。
结论
2
AIP是IR的危险因素,通过AIP可以预测T2DM患者患IR的风险,乳酸是IR危险因素,磷脂是IR的保护因素。
Objective
2
To explore the correlation between the atherogenic index of plasma (AIP) and insulin resistance (IR) in patients with type 2 diabetes mellitus (T2DM).
Methods
2
A total of 1 089 T2DM patients were collected. Using the HOMA⁃IR value of 2 as the threshold
the patients were divided into the non⁃insulin resistance group (N⁃IR) and insulin resistance group (IR). According to the AIP levels
the patients were divided into four groups (Q
1
Q
2
Q
3
and Q
4
) based on the quartile levels of AIP in the study subjects.
Results
2
(1) In the IR group
AIP was higher than in the N⁃IR group (
P
<
0.05). (2) Within the AIP groups
as AIP levels increased
HOMA⁃IR and the prevalence of IR also showed an increasing trend (
P
<
0.05). (3) In the Spearman correlation analysis
AIP showed a positive correlation with HOMA⁃IR (
P
<
0.001). (4) In the multifactor logistic regression of IR
an increase in AIP levels was associated with an increased risk of IR. For every 0.1 unit increase in AIP
the odds of IR increased by 22.9%. Lactic acid was identified as a risk factor for IR
while phospholipids were protective. (5) The ROC curve analysis yielded an area under the curve of 0.702 (95%
CI
: 0.664⁃0.739)
with the optimal diagnostic threshold being 0.0805.
Conclusion
2
AIP is a risk factor for IR. Through AIP
the risk of insulin resistance can be predicted in patients with T2DM. Lactic acid is a risk factor for IR
while phospholipids serve as a protective factor for IR.
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