Objective: To investigate the relationship between insulin resistance (IR) and dyslipidemia in adults with type 1 diabetes (T1DM) and provide more insights on diabetes-related cardiovascular disease management. Methods: A cross-sectional study recruiting patients from Guangdong T1DM Translational Study cohort was conducted between 2011 and 2017. The patients aged ≥18 years, with a diabetes duration of ≥1 year were enrolled in the study. Plasma lipid profile data of eligible patients, including total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C) were collected and their relationships with insulin resistance were analyzed. IR in these adults with T1DM was estimated by glucose disposal rate (eGDR) calculated by a model published previously. Patients with eGDR lower than 25 percentiles were grouped as severe IR, otherwise non-severe IR. Results: In total, 499 eligible patients were studied, among which 274 were women (54.9%). The level of eGDR was 8.43 (6.11, 10.63) mg kg(-1) min(-1) and the overall incidence of lipid disorders was 65.3% (326/499) in the study population. The result showed that eGDR was correlated with TC, TG, HDL-C and LDL-C (r=-0.163, -0.303, 0.170 and -0.150, respectively, all P<0.05). After adjusting for gender, age and diabetes duration, eGDR was still associated with TG, TC and LDL-C (all P<0.05). Stepwise multiple linear regression analysis showed that gender (female), elevated TC and declined HDL-C were independent factors associated with the severity of IR (t=5.651, 5.823 and 2.908, respectively, all P<0.05). Conclusions: IR is associated with dyslipidemiain in adults with T1DM. Elevated TC and decreased HDL-C are independent associated factors for insulin resistance.
目的： 分析成年1型糖尿病（T1DM）患者胰岛素抵抗与血脂紊乱的关系，为成年T1DM患者大血管并发症预防提供依据。 方法： 采用横断面研究的方法，选取广东省1型糖尿病转化医学研究数据库中2011至2017年入组的病程≥1年，且年龄≥18岁的T1DM患者499例。对该数据库中符合入选条件的研究对象总胆固醇（TC）、三酰甘油（TG）、低密度脂蛋白胆固醇（LDL-C）和高密度脂蛋白胆固醇（HDL-C）与胰岛素抵抗关系的密切程度进行分析。采用成人T1DM胰岛素抵抗估算模型估算葡萄糖处置率（eGDR）作为胰岛素抵抗程度的评价指标。将研究人群按eGDR的四分位数进行分组，其中eGDR小于第25百分位数（P(25)）的患者判定为胰岛素抵抗严重。 结果： 本研究共入选499例T1DM患者，其中女274例（54.9%）。研究人群eGDR水平为8.43（6.11，10.63）mg·kg(-1)·min(-1)，总体血脂紊乱发生率为65.3%（326/499）。eGDR与TC、TG、HDL-C和LDL-C均存在不同程度的相关性（r=-0.163、-0.303、0.170、-0.150，均P<0.05）。在调整了性别、年龄和病程后，TG、TC和LDL-C仍与eGDR相关（均P<0.05）。采用逐步多重线性回归模型分析结果显示，女性、高TC和低HDL-C与胰岛素抵抗严重程度独立相关（t=5.651、5.823、2.908，均P<0.05）。 结论： 成年T1DM患者胰岛素抵抗与血脂紊乱存在不同程度的关联。高TC和低HDL-C与成年T1DM患者胰岛素抵抗独立相关。.
Keywords: Cross-sectional study; Diabetes mellitus, type 1; Dyslipidemia; Insulin resistance.