不同糖耐量老年人胰岛β细胞功能及胰岛素敏感性指标的相关评价  

Correlated evaluation on the indexes of islet beta cell function and insulin sensibitity in elderly people with different glucose tolerance

作　　者：马博清[1] 宋光耀[1] 叶蔚[1] 薛树正[1] 张文杰[1] 王智华[1] 

机构地区：[1]河北省人民医院老年医学研究所,河北省石家庄市050071

出　　处：《中国临床康复》2004年第36期8212-8213,8219,共3页Chinese Journal of Clinical Rehabilitation

摘　　要：目的:探讨血清真胰岛素与免疫反应性胰岛素(immunoreactiveinsulin,IRI)在评价不同糖耐量老年人胰岛β细胞功能和胰岛素敏感性方面的不同。方法:2000-02/2001-02在河北省人民医院老年内分泌科健康查体及门诊就诊和住院治疗的老年人486例。纳入标准:口服葡萄糖耐量试验后用1999年WHO糖尿病诊断标准进行评估,分别符合糖耐量正常(normalglucosetolerance,NGT)、糖耐量减低(impairedglucosetolerance,IGT)和2型糖尿病诊断标准者;年龄≥60岁。排除标准:有慢性肝肾疾病;有急性感染、急性心脑血管疾病等应激情况等。符合上述标准患者118例。2型糖尿病患者39例(2型糖尿病组);IGT33例(IGT组);NGT46例(NGT组)。以上各组再按体质量指数分为两个亚组:非肥胖组(BMI<25kg/m2)和肥胖组(BMI≥25kg/m2)。均测定空腹IRI(RIA法)和真胰岛素(ELISA法)水平,计算胰岛β细胞功能指数和胰岛素抵抗指数,进行各组间的对比分析。结果:①2型糖尿病组的非肥胖亚组和肥胖亚组真胰岛素/IRI比率(0.32±0.22,0.28±0.11)均低于NGT组(0.38±0.19,0.39±0.16)和IGT组(0.36±0.13,0.37±0.16)(P均<0.05)。②IGT组和2型糖尿病肥胖组由IRI计算的胰岛β细胞功能指数(Homa-βIRI)低于NGT肥胖组(P均<0.05);AIM:To study the difference between serum true insulin and immunoreactive insulin(IRI) in evaluating the function of islet beta(β ) cell and insulin sensitivity of the elderly people with different glucose tolerance.<METHODS:There were 486 elderly people who were examined,treated and hospitalized in the Department of Senile Endocrinology,People's Hospital of Heibei Province during February 2000 to February 2001.Including criteria:in accordance with the WHO diagnostic standards of normal glucose tolerance(NGT),impaired glucose tolerance(IGT) and type 2 diabetes mellitus in 1999 by oral glucose tolerance test(OGTT),aged not younger than 60 years old.Excluding criteria:with acute infection,acute cardiovascular and cerebrovascular diseases and other stresses.Totally 118 cases met the above mentioned criteria were involved in the study,including 39 type 2 DM patients(ty2 DM group),33 IGT patients(IGT group) and 46 NGT cases(NGT group).Then each group was divided into 2 subgroups according to the body mass index(BMI):obesity subgroup (BMI ≥ 25 kg/m2) and non obesity subgroup(BMI< 25 kg/m2).Fasting IRI and true insulin(TI) were determined with radioimmunoassay and ELISA respectively,and the pancreatic β cell function index(Homa β ) and insulin resistance index(Homa IR) were calculated,then the results were compared and analyzed among the groups.<RESULTS:① The ratios of TI/IRI in the non obesity subgroup and obesity subgroup of the type 2 DM group(0.32± 0.22,0.28± 0.11) were lower than those of the NGT group(0.38± 0.19,0.39± 0.16) and IGT group(0.36± 0.13,0.37± 0.16)(both P< 0.05).② The Homa β calculated by IRI(Homa β IRI) in the obese subgroups of the IGT and type 2 DM groups were lower than that in the obese subgroup of the NGT group(P< 0.05). The Homa β calculated by TI(Homa β TI) in the non obesity subgroup of the IGT group was lower than that in the non obesity subgroup of the NGT group(P< 0.05),the Homa β TI in the non obesity subgroup of the DM group was lower t

关 键 词：老年人 葡萄糖耐量试验 胰岛素 胰岛素抗药性 

分 类 号：R587.1[医药卫生—内分泌]