中度烧伤患者BMI与胰岛素抵抗的相关性研究。

Agnieszka Surowiecka, Tomasz Korzeniowski, Patrycja Korulczyk, Julia Budzyńska, Magdalena Leśniewska, Ilona Kozioł, Zofia Górecka, Maciej Łączyk, Grzegorz Wilhelm, Małgorzata Staśkiewicz, Kamil Torres, Jerzy Strużyna
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引用次数: 0

摘要

& lt; b>介绍:& lt; / b>肥胖与可能影响愈合过程的严重合并症密切相关。身体质量指数(BMI)升高和胰岛素抵抗对代谢综合征的发展有重要影响,代谢综合征常导致致命的心血管并发症。本研究的目的是验证中度烧伤患者的BMI和胰岛素抵抗与临床参数的相关性。材料和方法:<;/b>;共有149名患者参加了这项研究,并对他们的临床资料进行了回顾性分析。在入院和出院时评估实验室检查、胰岛素需求、BMI和手术程序。结果:<;/b>;需要胰岛素治疗的烧伤患者入院时的实验室结果较差,与未接受胰岛素治疗的患者相比,他们的血红蛋白(HGB)水平较低(P = 0.0001),肌酐水平较高0.323单位(P = 0.009), c反应蛋白(CRP)升高约94单位(P = 0.0001),降钙素原(PCT)升高约0.5单位(P = 0.001)。此外,需要胰岛素治疗的烧伤患者在医院的平均住院时间延长了10天。所有胰岛素需求亚组患者入院时甘油三酯(Tg)水平均升高,胰岛素抵抗指标增加。我们的研究表明,较高的BMI对烧伤患者的保护作用,即所谓的“肥胖悖论”,可能会被胰岛素抵抗所削弱。结果表明,入院时Tg升高与BMI超过25kg / mg / kg并存。可作为一个重要的预后因素,并可帮助预测中度烧伤患者的胰岛素需求和更糟糕的结局。
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The correlation of BMI and insulin resistance in moderately burned patients.

<b>Introduction:</b> Obesity is strongly related to serious comorbidities that might affect the healing process. Elevated Body Mass Index (BMI) and insulin resistance have a significant impact on the development of the metabolic syndrome often leading to lethal cardiovascular complications.<b>Aim:</b> The aim of the study was to verify the correlation of BMI and insulin resistance with clinical parameters of moderately burned patients.<b>Materials and methods:</b> There were 149 patients enrolled in the study and their clinical data was retrospectively analyzed. The laboratory tests, insulin demand, BMI, and surgical procedures were evaluated on admission and discharge.<b>Results:</b> Burned patients who required insulin were characterized by worse laboratory results on admission to the burn unit, they had lower hemoglobin (HGB) levels (P = 0.0001), higher creatinine levels by 0.323 units (P = 0.009), higher C-reactive protein (CRP) by approximately 94 units (P = 0.0001), as higher procalcitonin (PCT) by approximately 0.5 units (P = 0.001) as compared to non-insulin-treated patients. Moreover, burned patients who required insulin stayed in the hospital for an average of 10 days longer. All patients from the insulin-demand subgroup had elevated triglycerides (Tg) levels on admission with increased indexes of insulin resistance.<b>Discussion:</b> Our study suggests that the protective effect of a higher BMI in burned patients, known as the 'obesity paradox' may be compromised by insulin resistance.<b>Conclusions and significance of the study:</b> The results show that elevated Tg on admission to the burn unit coexisting with a BMI over 25 kg/m<sup>2</sup> may be used as an important prognostic factor and may help with prediction of insulin demand and worse outcome in moderately burned patients.

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