三级医院非糖尿病性慢性心力衰竭患者胰岛素抵抗与LVEF的关系

Azharul Islam, M. Mahmood, Khurshed Ahmed, S. Banerjee, S. Ahsan, C. M. Ahmed, A. I. Akand, Saha Sk, Fysal Faruq, Kamruzzman Siddiki, Akm Fazlur Rahman, F. I. Khaled, S. Zaman, F. Yeasmin, P. Akter, H. Hoque
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摘要

背景:胰岛素抵抗是一个公认的全身性炎症和代谢紊乱的综合指标。评估胰岛素抵抗的方法有HOMA-IR(稳态模型评估胰岛素抵抗)、fgil(空腹葡萄糖胰岛素比率)、ISI-Composite(全身胰岛素敏感性指数)、QUICKI(胰岛素敏感性定量检查指数)等。目的:探讨非糖尿病性慢性心力衰竭患者胰岛素抵抗与LVEF的关系。方法:本横断面研究于2019年2月至2020年6月在达卡沙赫巴格的Bangabandhu Sheikh Mujib医科大学心内科进行。入院的慢性心力衰竭伴射血分数降低的患者纳入本研究。糖尿病患者、糖尿病前期患者和未给予书面知情同意的患者被排除在本研究之外。结果:16例患者LVEF 25-29%,其中10例(66.7%)有明显的胰岛素抵抗。28例患者LVEF 30 ~ 34%,其中16例(41.0%)无胰岛素抵抗。19例患者LVEF 35 ~ 39%,其中18例(46.2%)无胰岛素抵抗。差异有统计学意义(p<0.05)。负相关(r=-0.340;p=0.006)。结论:非糖尿病性慢性心力衰竭患者多数不存在胰岛素抵抗。胰岛素抵抗与LVEF呈显著负相关。《大学心脏杂志》第17卷第2期,2021年7月;99 - 102
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Correlation between Insulin Resistance and LVEF in non Diabetic Chronic Heart Failure Patients admitted in a Tertiary Care Hospital
Background: Insulin resistance is a well-established composite index of systemic inflammatory and metabolic disorders. A wide variety of methods like, HOMA-IR (Homeostatic model assessment insulin resistance), FGIR (Fasting glucose insulin ratio), ISI-Composite (an index of whole body insulin sensitivity), QUICKI (quantitative insulin sensitivity check index) etc are available for assessing IR. Objective: To find out the correlation between insulin resistance and LVEF in non diabetic chronic heart failure patients. Methodology: This cross sectional study was carried out in the Department of Cardiology in Bangabandhu Sheikh Mujib Medical University, Shahbagh, Dhaka from February, 2019 to June, 2020. Patients admitted with chronic heart failure with reduced ejection fraction were included in this study. Patients with diabetic, prediabetic and patient who did not give written informed consent were excluded in this study. Results: LVEF 25-29% was 16 patients out of which 10(66.7%) had significant insulin resistance. LVEF 30- 34% was found in 28 patients, among them 16(41.0%) had no insulin resistance. LVEF 35-39% was found in 19 patients out of which 18(46.2%) had no insulin resistance. The difference was statistically significant (p<0.05). A negative correlation (r=-0.340; p=0.006) was found between insulin resistance and LVEF. Conclusion: Majority non diabetic chronic heart failure patients had no insulin resistance. Significant negative correlation was found between insulin resistance and LVEF. University Heart Journal Vol. 17, No. 2, Jul 2021; 99-102
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