目的 探討糖脂代謝在膽囊結石形成中的作用。
方法 收集1998年1~4月 25例膽囊結石患者和25例自愿者,并應用性別和年齡進行個體配對(1∶1),測量所有研究對象的體重指數(shù)(BMI)和腰臀比(W/H),并采空腹靜脈血測定血糖、糖化血紅蛋白(HbA1C)、胰島素、C肽以及血脂全套指標,采血后研究對象立即口服75g葡萄糖,2小時后再測定血糖、胰島素、C肽。
結果 結石組與對照組的BMI和W/H無明顯統(tǒng)計學差異。兩組空腹血糖、HbA1C及2小時血糖差異無統(tǒng)計學意義(P gt;0.05、 P gt;0.2、 P gt;0.1)。結石組中糖代謝異常10例,占40%(7例糖尿病,3例糖耐量減低),對照組糖代謝異常4例(1例糖尿病,3例糖耐量減低),差異有顯著性意義(P lt;0.05)。結石組空腹及2小時胰島素平均濃度明顯高于對照組(P lt;0.02, P lt;0.05),結石組空腹C肽亦高于對照組(P lt;0.05)。結石組中高胰島素血癥14例,對照組2例,差異有顯著性意義(P lt;0.01)。兩組血脂各項指標(TG、TC、HDL-C、LDL-C、VLDL-C)無統(tǒng)計學差異。
結論 糖尿病和胰島素水平升高在膽囊結石形成中可能有重要作用。
引用本文: 徐知非,田奇,何生. 膽囊結石與糖脂代謝關系的探討. 中國普外基礎與臨床雜志, 2001, 8(3): 159-161下轉163. doi: 復制
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- 1. Aucott JN, Cooper GS, Bloom AD, et al. Management of gallstones in diabetic patients 〔J〕. Arch Intern Med, 1993; 153(9)∶1053.
- 2. Diehi AK. Epidemiology and natural history of gallstone disease 〔J〕. Gastroenterol Clin North Am, 1991; 20(1)∶ 1.
- 3. 陳灝珠,李宗明主編. 肥胖癥,內科學 〔M〕.第3版. 北京:人民衛(wèi)生出版社,1992∶751~752.
- 4. 吳同法. 膽石癥,實用內科學(下冊) 〔M〕. 第10版.北京:人民衛(wèi)生出版社,1997∶1717~1718.
- 5. 顧土芬,王昌城,俞衛(wèi)男等. 糖尿病與膽石病關系的臨床探討 〔J〕.醫(yī)師進修雜志,1994; 17(3)∶15.
- 6. Mcsherry CK, Ferstenberg H, Calhoun WF, et al. The natural history of dignosed gallstone disease in symptomatic and asyptomatic patients 〔J〕. Ann Surg, 1985; 202(1)∶59.
- 7. Ikard RW. Gallstones, cholecystitis and diabetes 〔J〕. Surg Gynecol Obstet, 1990; 171(6)∶528.
- 8. 陳筠,孫承智,魏文京等. 膽囊結石并發(fā)糖尿病8例分析 〔J〕.山西醫(yī)藥雜志, 1994; 23(6)∶372.
- 9. Laakso M, Suhonen M, Julkunen R, et al. Plasma insulin, serum lipids and lipoproteins in gallstone disease in non-insulin dependent diabetic subjects: a casecontrol study 〔J〕. Gut, 1990; 31(3)∶344.
- 10. Chait A, Bierman EL, Albers JJ, et al. Lowdensity lipoprotein receptor activity in cultured human skin fibroblawt. Mechanism of insulininduced stimulation 〔J〕. J Clin Invest, 1979; 64(5)∶1309.
- 11. 顧土爵主編. 膽固醇合成的調節(jié),生物化學〔M〕. 第3版. 北京:人民衛(wèi)生出版社, 1990∶204~206.
- 12. Olefsky JM, Farguhar JM, Reaven GM, et al. Reappraisal of the role of insulin in hypertriglyceridemia 〔J〕. Am J Med, 1974; 57(4)∶551.
- 13. 黃熙,王竹平,張英民等. 血清胰島素與膽囊結石關系的研究〔J〕. 中華實驗外科雜志,1994; 11(6)∶347.
- 14. Caroli A. Lipids pattern and plasma insulin in diabetes with gallstones 〔J〕. Gut, 1991; 32(3)∶339.
- 15. Scragg RK, Galvert CD, Diver JR, et al. Plasma lipids and insulin in gallstones disease: a case control study 〔J〕. British Med J, 1984; 289(6444)∶521.
- 16. Bailey CJ, Ahmed-Sorour H. Role of ovarian hormone in long term control of glucose hameostasis: effect on insulin secretion 〔J〕. Diabetologia, 1980; 19(5)∶475.
- 17. 付賢波,沈韜,周孝思等. 血脂水平與膽囊結石的關系 〔J〕. 中華醫(yī)學雜志, 1991; 71(3)∶136.
- 18. Kono S, Kochi S, Ohyama S, et al. Gallstone, serum lipids and glucose tolerance among male officials of selfdefence force in Japan 〔J〕. Dig Dis Sci, 1988; 33(7)∶839.