胰岛素抵抗与特发性扩张型心肌病:一种可能的病因学联系

作     者：Witteles R.M. Tang W.H.W. Jamali A.H. M.B. Fowler 郝广华 

作者机构：Division of Cardiov ascular Medicine Stanford Univ. School of Medicine Stanford CA United States 

出 版 物：《世界核心医学期刊文摘（心脏病学分册）》 (Digest of the World Core Medical Journals(Cardiology))

年 卷 期：2005年第1卷第1期

页      面：39-40页

学科分类：1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学] 

主　　题：胰岛素抵抗 病因学 缺血性心肌病 糖耐量异常 口服葡萄糖 血浆葡萄糖 伴发疾病 定量研究 血浆胰岛素 一所 

摘      要：Objectives This study was designed to quantify the prevalence of abnorm al gluc ose tolerance and insulin resistance in patients with idiopathic dilated cardiom yopathy (IDCM). Background Insulin resistance is an independent risk factor for mortality in patients with heart failure(HF) and is a known risk factor for isch emic cardiomyopathy. Though potential physiologic links between insulin resistan ce and HF have been hypothesized, the relationship between insulin resistance an d IDCM remains unclear. Methods A total of 230 consecutive patients from a unive rsity HF clinic were screened for IDCM, the absence of diabetes mellitus, and th e lack of significant co-morbid conditions. Oral glucose tolerance tests were p erformed in the 43 patients with IDCM who met these criteria, and their plasma glucose and insulin responses we re compared with those of 40 healthy volunteers, matched for age, gender, and bo dy mass index. Results Plasma glucose responses were higher during the oral gluc ose tolerance tests in patients with IDCM (p 0.01), associated with significant ly higher plasma insulin concentrations following the oral glucose challenge(p 0.01). In addition, abnormalities of glucose tolerance were significantly(p 0.0 5) more common in patients with IDCM (49%vs. 23%). Conclusions Insulin resista nce and abnormal glucose tolerance are more prevalent in patients with IDCM and represent potentially reversible metabolic derangements in these individuals.