不同糖代谢状态人群胰岛素抵抗和胰岛β细胞功能研究  

Insulin resistance and function of islet β cell in Chinese with different status of glucose metabolism

作　　者：董砚虎[1] 付方明[1] 高维国[1] 李红[1] 南海荣[1] 孙滨[1] 丁明[1] 李利平[1] 石海燕[1] 马臻[1] 王元善[1] 王丽华[1] 

机构地区：[1]青岛市内分泌糖尿病研究所暨医院潍坊医学院研究生培养基地,266071

出　　处：《中华内分泌代谢杂志》2004年第3期193-196,共4页Chinese Journal of Endocrinology and Metabolism

摘　　要：目的　探讨从正常糖耐量到糖尿病 (DM )不同糖代谢水平 ,胰岛素抵抗 (IR)与胰岛 β细胞功能的演变。方法　青岛市区 3 0～ 74岁的正常糖耐量 (NGT ) 44 7例 ;空腹血糖受损 (IFG) 14 2例 ;糖耐量受损 (IGT) 93例 ;IFG合并IGT(IFG +IGT) 42例 ;新诊DM 15 3例。采用HOMA IR评价IR ,HOMA β、ΔI3 0 /ΔG3 0 分别评价基础状态下及糖负荷后的早期胰岛 β细胞功能。 结果　IFG组HOMA IR为 1.14± 0 .0 6,明显高于NGT组的 0 .93± 0 .0 3 (P <0 .0 5 ) ,IFG组HOMA β为 4.5 3± 0 .0 6,低于NGT组 5 .10± 0 .0 4(P<0 .0 5 ) ,两组间△I3 0 /△G3 0 差异无显著性 ( 4 .86± 0 .11vs 4.99± 0 .11) ;IGT组HOMA IR为 1.12± 0 .0 7,明显高于NGT (P <0 .0 5 ) ,两组间HOMA β差异无显著性 ,IGT组△I3 0 /△G3 0 为 4.62± 0 .14 ,低于NGT组的 4.99± 0 .11(P <0 .0 5 ) ;DM组HOMA IR为 1.5 5± 0 .0 5 ,明显高于NGT、IGT和IFG组 (P <0 .0 5 ) ,DM组HOMA β和△I3 0 /△G3 0 分别为 3 .94± 0 .0 6、3 .93± 0 .12 ,明显低于其他各组 (P <0 .0 5 ) ,DM组基础与糖负荷后的胰岛 β细胞功能均明显受损。 结论　IFG患者主要表现 β细胞功能缺陷 ,IGT为胰岛素早期分泌受损 ,DM患者兼有严重的IR和β细胞缺陷。从NGT到DM ,?Objective To investigate the changes of insulin resistance (IR) and function of islet β cell in Chinese with different status of glucose metabolism. Methods Isolated impaired fasting glucose (IFG, n=142), isolated impaired glucose tolerance (IGT, n=93), combined IFG and IGT (IFG+IGT, n=42), newly diagnosed diabetes (DM, n=153) were studied. Subjects of normal glucose tolerance (NGT, n=447) were randomly selected from residents living in the same community of the patients. Fasting, 30 and 120 min plasma glucose and serum insulin during 75 g oral glucose tolerance test (OGTT) were measured. Homeostasis model assessment (HOMA) was applied to assess the status of insulin resistance (HOMA-IR), and HOMA-β and the ratio of the increment of insulin to that of plasma glucose of the initial 30 min during OGTT (△I 30/△G 30) were used to evaluate the basic function and the early phase of insulin secretion of islet β cells respectively. Results As compared with NGT, age, waist circumference, body mass index (BMI), blood pressure, 120 min glucose were elevated in other 4 groups. Adjusted with age and sex, HOMA-IR was higher in subjects with IFG (1.14±0.06), IGT (1.12±0.07) and IFG & IGT than that with NGT (0.93±0.03) (P<0.05), however, there was no difference among IFG, IGT, and IFG & IGT. Compared with subjects in NGT, subjects with IFG had lower HOMA-β(4.53±0.06 vs 5.10±0.04, P<0.05), while there was no difference in △I 30/△G 30. Individuals with IGT showed lower △I 30/△G 30 than that with NGT (4.62±0.14 vs 4.99±0.11, P<0.05), but no difference in HOMA-β. Compared with subjects in IFG, HOMA-β increased in subjects with IGT (5.11±0.07 vs 4.53±0.06, P<0.05), although no difference was found in △I 30/△G 30. At the same time, subjects with DM had more severe IR (1.55±0.05 , P<0.05) and basic and postload dysfunction of β cell compared with other groups (3.94±0.06;3.93±0.12, both P<0.05). Conclusion The individuals with IFG mainly showed defect of basic β cell funct

关 键 词：糖代谢 胰岛素抵抗 胰岛Β细胞功能 空腹血糖受损 糖尿病 

分 类 号：R587.1[医药卫生—内分泌]