Study Of Intervention Of Insulin Resistance On IGT At The Early Time

Background:Insulin Resistance(IR)refers to the peripheral insulin target tissues suchas the liver,skeletal muscle and adipose tissue that reduced sensitivity toendogenous or exogenous insulin,leading to physiological doses ofinsulin that produces lower physiological effect.Due to the long-terminsulin resistance and hyperinsulinemia can cause a series of clinicalabnormalities,such as Impaired Glucose Tolerance(IGT) or Type2Diabe-tes Mellitus(T2DM),Hypertension,Hyperlipidemia,Polycystic Ovarian S-yndrome,Hypercoagulable States,Microalbuminuria,Hyperuricemia,Obe-sity et al,totally referred to as the Insulin Resistance Syndrome,alsoknown as Metabolic Syndrome (MS).The generation of IR has complex genetic factors and environmentalfactors, especially has a great relationship with the unhealthy lifestyle.The etiology of IR related to obesity,glucotoxicity,diet,exercise,smoking,pregnancy and so on.The mechanism of IR is very complex, and wereassociated with the defects of target tissues of insulin receptors on thecell,post-receptor and molecular structure and function,in addition,also r-elated to the abnormal of hormones which are regulated by insulin.Objective:Early intervention of insulin resistance in clinical aims to prevent or delay the occurrence of Type2Diabetes Mellitus,so as to achieveeffectively in reducing the occurrence of diabetes and cardiovasculardisease and providing effective treatment and evaluation criteria, therebyimproving the quality of life for IGT.Methods:From January2014to October2014the normal physical examinationpopulation in our hospital,through Oral Glucose Tolerance Test(OGTT)and according to the1999WHO diagnostic criteria for diabetes,screeningout the observation group: IGT with hypertension and hyperlipidemia(32cases,including17males and15females) and IGT withouthypertension and hyperlipidemia(28cases,including14males and14females),the control group(NGT)(30cases,including15males and15females).These were total90cases, with an average age of (45.8±9.6).Establishing follow-up files.The BMI of the two groups was randomlyassigned,which antihypertensive drugs and Lipid-lowering drugs weregiven IGT with hypertension and hyperlipidemia(hypertensive patients orhyperlipidemic patients need to stop taking drugs for2weeks),lifeinterventions were given IGT without hypertension and hyperlipidemia.Choosing ACEI or ARB as the antihypertensive,Statins as theLipid-lowering drugs.The control group was not given any interventions,reviewing of these indicators periodicly.Collecting patients＇age,sex,height,weight,blood pressure, Fast plasma glucose,2-hour Post plasma glucose, Hemoglobin C,Fasting insulin,2-hour Posting insulin,Triglyceride,Total Cholesterol,High density lipopro-tein,Low density lipoprotein and so on.Reviewing these indicators after6months.All the datas were analyzed by statistical software SPSS13.0,andwere showed with x士S，the mean of the muti-sample were comparedby one-way analysis of variance,pre-and post-intervention in the samegroup were compared by paired t-test,p<0.05represents statisticalsignificance.Results:After the intervention SBP,DBP,TG,TC and LDL were obviouslydecreased in IGT with hypertension and hyperlipidemia,with statisticalsignificance(p<0.05);HDL was obviously increased,with statisticalsignificance(p<0.05);But FBG,2hPG,HbA1C showed no obviouslychange,without statistical significance(p>0.05).After the interventionFBG,2hPG,BMI and HbA1C were decreased obviously in IGT withouthypertension and hyperlipidemia,with statistical significance(p<0.05).TheHOMA-insulin resistance were decreased obviously in the observationgroup,with statistical significance(p<0.05).Conclusion:For patients with Impaired Glucose Tolerance by lowering bloodpressure,lowering lipids or changing lifestyle at the early time can reduceinsulin resistance,providing effective measures to prevent IGT to develop to DM or cardiovascular disease.