标题：新发2型糖尿病患者睡眠时间与胰岛素抵抗的相关性

      作者：王环君，皮银珍，杨腾舜，李琳，刘罗坤，胡丽    (长沙市第一医院内分泌代谢科，湖南 长沙 410005)

      卷次： 2016年27卷24期

      【摘要】 目的 探讨新发2型糖尿病患者睡眠时间与胰岛素抵抗的相关性。方法 选取2014-2015年在我院内分泌代谢科住院的新发2型糖尿病患者72例，根据睡眠时间长短分为睡眠时间<6 h/晚、6~8 h /晚、>8 h /晚三个组。记录并比较三组患者的一般情况、体质量指数(BMI)、糖化血红蛋白(HbA1c)、总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白(LDL)、高密度脂蛋白(HDL)、空腹血糖(FPG)、空腹胰岛素(FINS)，以胰岛素抵抗指数(HOMA-IR)来评价胰岛素抵抗。结果 在新发2型糖尿病中，与睡眠时间6~8 h/晚组相比，睡眠时间<6 h/晚组患者的BMI、腰围、收缩压(SBP)、舒张压(DBP)、TG、LDL、FPG、FINS、HOMA-IR、HbA1c等明显增高，HDL明显降低，差异均有统计学意义(P<0.05)；与睡眠时间 6~8 h/晚组相比，睡眠时间>8 h/晚组患者的 BMI、腰围、TG、LDL、FPG、FINS、HOMA-IR、HbA1c明显增高，差异均有统计学意义(P<0.05)；与睡眠时间<6 h/晚组相比，睡眠时间>8 h/晚组患者的SBP、DBP、LDL、FPG、FINS、HOMA-IR、HbA1c明显降低，差异有统计学意义(P<0.05)。结论 睡眠时间不足或过长都有可能出现血脂、血糖、血压等的升高，导致代谢紊乱，加重胰岛素抵抗，尤其是睡眠时间不足影响更明显，可能是新发2型糖尿病的危险因素。
      【关键词】 新发2型糖尿病；睡眠时间；胰岛素抵抗；相关性
      【中图分类号】 R587.1 【文献标识码】 A 【文章编号】 1003—6350（2016）24—3991—03

Relationship between sleep duration and insulin resistance in patients with newly diagnosed type 2 diabetesmellitus.
WANG Huan-jun, PI Yin-zhen, YANG Teng-shun, LI Lin, LIU Luo-Kun, HU Li. Department of Endocrine andMetabolic Diseases, the First Hospital of Changsha, Changsha 410005, Hunan, CHINA
【Abstract】 Objective To study the relationship between sleep duration and insulin resistance in patients withnewly diagnosed type 2 diabetes mellitus. Methods A total of 72 patients with newly diagnosed type 2 diabetes melli-tus in Department of Endocrine and Metabolic Diseases in our hospital from 2014 to 2015 were selected. According tothe length of sleep duration, all patients were divided into 3 groups by the sleep time: <6 h/night (group A), 6~8 h/night(group B) and >8 h/night (group C). The general situations, body mass index (BMI), hemoglobin A1c level (HbA1c), to-tal cholesterol (TC), triglyceride (TG), low density lipoprotein (LDL), high density lipoprotein (HDL), fasting plasmaglucose (FPG), fasting insulin concentration (FINS) were recorded and compared, and the insulin resistance was as-sessed by homeostasis model assessment of insulin resistance (HOMA-IR). Results Compared with the group B, theBMI, waist circumferences, systolic blood pressur (SBP), diastolic blood pressure (DBP), TG, LDL, FPG, FINS,HOMA-IR, HbA1c of group A were significantly increased, and the HDL was significantly reduced in patients with newlydiagnosed type 2 diabetes, with statistically significant differences (P<0.05). Compared with the group B, the BMI, waistcircumferences, TG, LDL, FPG, FINS, HOMA-IR, HbA1c in group C were significantly increased, and the differenceswere statistically significant (P<0.05). Compared with the group A, the SBP, DBP, LDL, FPG, FINS, HOMA-IR, HbA1cin group C were significantly reduced, and the differences were statistically significant (P<0.05). Conclusion Both theshort sleep duration and the long sleep duration could result in the rise of blood lipids, blood pressure and blood glucose,then cause metabolic disturbance and aggravate insulin resistance. In particular, the former's effect is more obvious,which may be a risk factor for newly diagnosed type 2 diabetes mellitus.
      【Key words】 Newly diagnosed type 2 diabetes mellitus; Sleep duration; Insulin resistance; Relationship·论 著·doi:10.3969/j.issn.1003-6350.2016.24.011