2型糖尿病患者一级亲属中糖耐量状况和胰岛素抵抗及其与胰岛β细胞功能的观察  

Study on the association of abnormal glucose tolerance of first degree relatives of type 2 diabetics with insulin resistance and β cell function

作　　者：陈明卫[1] 杨明功[1] 王长江[1] 王佑民[1] 刘树琴[1] 章秋[1] 包爱民[1] 孙海燕[1] 

机构地区：[1]安徽医科大学第一附属医院内分泌科,合肥230032

出　　处：《中华糖尿病杂志（1006-6187）》2004年第6期405-408,共4页

基　　金：安徽省教育厅自然科学基金资助项目 (96JL0 0 68)

摘　　要：目的　探讨 2型糖尿病 (T2DM )患者一级亲属中糖代谢异常和胰岛素抵抗 (IR)与胰岛β细胞功能缺陷的关系。 　方法　对 78个T2DM核心家系中 5 30例T2DM患者一级亲属进行口服葡萄糖耐量试验 (OGTT) ,不包括受检前已明确诊断为糖尿病 (DM )者 ;选择 12 1例非DM非糖耐量异常的同胞配偶为正常对照组。应用HOMA IR ,ΔI3 0 /ΔG3 0 (包括ΔI3 0 ·ΔG3 0 -1·HOMA IR-1)来分别评估胰岛素敏感性和胰岛 β细胞功能。并分析HOMA IR和ΔI3 0 /ΔG3 0 (包括ΔI3 0 ·ΔG3 0 -1·HOMA IR-1)与OGTT中曲线下增加的葡萄糖面积 (AUCg)之间的相关性。　结果　 5 30例T2DM患者一级亲属中新诊断DM 80例 ,患病率为 15 % ;空腹血糖受损和糖耐量受损 (IFG和IGT)患病率为 32 % ;糖耐量正常 (NGT)为 5 3%。随着糖耐量降低 ,HOMA IR明显增加 ,ΔI3 0 /ΔG3 0 (包括ΔI3 0 ·ΔG3 0 -1·HOMA IR-1)明显降低 (P <0 0 5～ 0 0 1)。NGT组的ΔI3 0 /ΔG3 0 、ΔI3 0 ·ΔG3 0 -1·HOMA IR-1显著低于正常对照组。HOMA IR ,常用对数转换后的ΔI3 0 ΔG3 0 以及ΔI3 0 ·ΔG3 0 -1·HOMA IR-1均与AUCg呈线性相关关系 (r分别为 0 2 89,- 0 5 6 6 ,- 0 6 93,P均 <0 0 1)。　结论　T2DM患者一级亲属中 。Objective To explore the association of abnormal glucose tolerance of first degree relatives of type 2 diabetics with insulin resistance and β cell function Methods 530 first degree relatives with no known history of diabetes from 78 type 2 diabetes nuclear families underwent an oral glucose tolerance test(OGTT) 121 subjects of their spouses were selected as control group The homeostasis model assessment of insulin resistance (HOMA IR) was used to estimate insulin sensitivity; β cell function was quantified as the ratio of the incremental insulin to glucose responses over the first 30 min (△I 30 /△G 30 ) during the OGTT The latter measure was also adjusted for the assay of insulin sensitivity as it modulated β cell function (△I 30 ·△G 30 -1 ·HOMA IR -1 ) The relationships of insulin sensitivity and β cell function with glucose disposal, which was measured by the incremental glucose area under the curve(AUC g),were examined in the whole cohort Results Newly identified diabetics were found in 15% ( n =80),and impaired fasting glucose (IFG) and/or impaired glucose tolerance (IGT) in 32%( n =170) Only 53% ( n =280) had normal glucose tolerance (NGT) Decreased glucose tolerance was associated with increased insulin resistance and decreased β cell function ( P <0 05～0 01) Decreased β cell function was also identified when adjusting this measure for insulin sensitivity (△I 30 ·△G 30 -1 ·HOMA IR -1 ) ΔI 30 /ΔG 30 and ΔI 30 ·ΔG 30 -1 ·HOMA IR -1 were significantly lower in NGT than that in control group Insulin sensitivity,log (△I 30 /△G 30 ) and log (△I 30 ·△G 30 -1 ·HOMA IR -1 ), were all linearly related to AUC g ( r =0 289,-0 566,-0 693,respectitvely, P <0 01) Conclusion Abnormal glucose metabolism is common in first degree relatives of T2TM cases Insulin resistance, and especially important impair

关 键 词：一级亲属 患者 IR 胰岛Β细胞功能 诊断 T2DM 糖耐量 胰岛素抵抗 糖代谢异常 OGTT 

分 类 号：R587.1[医药卫生—内分泌] R714[医药卫生—内科学]