餐后1h血糖升高的糖耐量正常人群胰岛β细胞功能及胰岛素敏感性变化  

Changes of islet β-cell function and insulin sensitivity in normal glucose tolerance individuals with 1 hour postprandial hyperglycemia during OGTT

作　　者：何扬[1] 王力[1] 曾满风 陈树梅[1] 袁琳[1] 

机构地区：[1]珠海市人民医院,广东珠海519000

出　　处：《山东医药》2013年第30期24-27,共4页Shandong Medical Journal

基　　金：珠海市卫生局科研基金资助项目(2012089)

摘　　要：目的 观察餐后1h血糖升高的糖耐量正常人群胰岛β细胞功能及胰岛素敏感性的变化.方法 124例受试者,均行口服葡萄糖耐量试验,根据结果分为糖调节受损(IGR)的A组51例、餐后1h血糖≥8.9 mmol/L但糖耐量正常的B组22例和餐后1h血糖正常糖耐量正常的C组51例.三组均依次进行口服葡萄糖—胰岛素释放试验(OG-IRT)、静脉葡萄糖耐量试验(IVGTT).结果 B组BMI、收缩压、舒张压低于A组(P均＜0.05),与C组比较差异无统计学意义.B组腰围大于C组(P＜0.05),与A组比较差异无统计学意义.B组CHOL、TG、LDL-C与A、C组比较差异均无统计学意义.口服75 g葡萄糖后,三组血糖较基础值均升高,A组60 min,B、C组30 min达高峰.口服75 g葡萄糖后,三组血清SI较基础值明显增加,C组30 min,B组30～60 min,A组60 ～ 120 min达高峰.空腹胰岛素原(PI0h)B组与A、C组相比差异均无统计学意义.餐后2h胰岛素原(PI2h)B组较C组升高,但低于A组(P均＜0.05).B组AI30/AG30低于组降低,但高于A组(P均＜0.05);SI低于C组,但高于A组(P均＜0.05).静脉注射25 g葡萄糖后,三组血糖及SI迅速上升,2 min达高峰;胰岛素分泌高峰出现在3～5 min.B组AIR0-10低于C组,但高于A组(P均＜0.05).结论 餐后1h血糖异常的糖耐量正常人群已有胰岛β细胞分泌功能受损及胰岛素抵抗.Objective To observe the changes of isletβ-cell function and insulin sensitivity in normal glucose tolerance individuals with 1 hour postprandial hyperglycemia during oral glucose tolerance test( OGTT). Methods A total of124 subjects,including 51 impaired glucose regulation( IGR) individuals( group A),51 normal 1-hour post-load plasma glucose individuals with normal glucose tolerance( group C) and 22 1-hour post-load hyperglycemia individuals( blood glucose≥8. 9 mmol / L) with normal glucose tolerance( group B) were selected,and these 3 groups all underwent OGTT.Measurements of β-cell function including oral glucose-insulin release test( OG-IRT),intravenous glucose tolerance test( IVGTT) were conducted in group A,B and C. Results The levels of the BMI,systolic blood pressure and diastolic blood pressure in group B were significantly lower than those of group A( all P < 0. 05),while there were no significantly differences between group B and C. The levels of waist circumference in group B were significantly higher than those of group C( all P < 0. 05),while there were no significantly differences between group B and group A. No significant differences were found in the levels of CHOL,TG and LDL-C of three groups. After oral administration of 75 g glucose,the levels of plasma glucose were increased compared to the baseline values in three groups,and group A reached the peak at 60minutes,group B and C at 30 minutes. The levels of serum SI were rapidly increased in three groups after oral administration of 75 g glucose,and group C reached the peak at 30 minutes,group B at 30-60 minutes,group A at 60-120 minutes.No significant differences were found in the levels of the fasting proinsulin( PI0h) between group B and group A,C. The levels of the post-load 120 minutes proinsulin( PI2h) in group B were significantly higher than those of group C but significantly lower than those of group A( all P < 0. 05). The levels of theΔI30/ ΔG30and SI in group B were significantly lower than those of group C but significantly h

关 键 词：糖耐量试验 糖负荷后高血糖 胰岛素 胰岛素抵抗 

分 类 号：R363[医药卫生—病理学]