The Study On The Relationship Of Blood Lipid And Insulin Resistance In Type 2 Diabetes Mellitus

As the change of the life style and the structure of food and drink in recent years, the disease incidence of obesity and diabetes mellitus in the world is dramatic increasing. Obesity has the intimate relation with the genesis and development of the diabetes mellitus. A general opinion, obesity plays an important role in inducing the cause and aggravating the agent in the morbility of diabetes mellitus. Many type 2 diabetes mellitus companied with obesity, chaotic blood lipid and insulin resistance. In the lipid metabolism disordering, the heightened LDL-C will increase the incidence rate of the coronary atherosclerotic heart disease (CHD) and macroangiopathy; The degraded HDL-C will prognosticate the genesis and development of the artherosclerosis; Nevertheless the heightened TG will aggravate the insulin resistance, the insulin resistance will accelerate the genesis and development of the diabetes mellitus's complication. The interaction of above all the factors will make the pathogenetic condition of obese the type 2 diabetes mellitus complicated and serious.Objective:To study the association of blood lipid and insulin resistance between the obese and non-obese type 2 diabetes mellitus, so as to provide more efficient diagnose, precaution and cure method.Materials and methods: A total of 128 newly diagnosed type 2 diabetes mellitus patients in out and in-patients in the First Hospital of Jilin University from July, 2006 to December, 2007. The 128 newly diagnosed type 2 diabetes mellitus patients according to《The companion of precaution and control on overweight and obesity in Chinese adult》criteria were classified into two groups: non-obese type 2 diabetes mellitus (A group) (45cases, BMI<28kg/m2, 28 males and 17 females, average aged 46.6 years old) and obese type 2 diabetes mellitus (B group) (83 cases, BMI≥28kg/m2, 49 males and 34 females, average aged 45.36 years old). Another two groups, also according to《The companion of precaution and control on overweight and obesity in Chinese adult》criteria, obese type 2 diabetes mellitus were classified into 2 groups: DM with abdominal obesity (C group) (44 cases, male WC≥85cm,female WC≥80cm, 22 males and 22 females, average aged 43.48 years old); DM with non-abdominal obesity (D group) (39 cases, male WC<85cm, female WC<80cm, 27 males and 12 females, average aged 47.49 years old). The diagnosis of T2DM accorded with the new diagnostic criteria of WHO in 1999: Fasting plasma glucose (FPG)≥7.0mmol/L, Random blood sugar (RBS)≥11.1mmol/L or Oral glucose tolerance test (OCTT) 2 hours blood glucose≥11.1mmol/L. Compared the differences of the common conditions, fasting insulin, blood lipid and so on in four groups and analyzed the association of blood lipid and insulin resistance between the obese and non-obese type 2 diabetes mellitus.Result:1,There was no difference in age, sexuality among four groups. Compared with A group, body mass index (BMI) and WHR were higher in B group (P<0.01). There was no difference in BMI between C and D groups (P>0.05), Compared with D group, WHR was higher in C group (P<0.01).2,Compared with A group, triglyceride (TG), TC and LDL-C were higher but HDL-C was lower in B, C and D groups (P<0.05). Compared with D group, TG,TC and LDL-C were higher but HDL-C was lower in C group (P<0.05).3,There was no difference in FBG among four groups. Compared with A group, the level of fasting insulin and HOMA-IR were higher in B,C and D groups (P<0.05). Compared with D groups, the level of fasting insulin and HOMA-IR were higher in C group (P<0.01).Conclusion:1,Obesity (especially abdominal obesity) is a most independent risk factor for T2DM and insulin resistance, obesity play the important role in inducing the cause of disease and aggravating the agent in the morbility of diabetes mellitus.2,As for T2DM, chaotic blood lipid is an independent risk factor. Many T2DM companied with obvious chaotic blood lipid and insulin resistance, especially abdominal obesity in T2DM.3,Obese T2DM especially abdominal obesity, existence more serious chaotic blood lipid and insulin resistance, Controlling body weight may abatement chaotic blood lipid and insulin resistance, reduce and delay the genesis and development of the diabetes mellitus's complications.