52例肥胖和超重儿童糖耐量及胰岛素释放试验分析  

Oral glucose tolerance and insulin release test in 52 cases of obese and overweight children

作　　者：孙文鑫[1] 王伟[1] 王德芬[1] 崔贻芬[1] 

机构地区：[1]上海第二医科大学附属瑞金医院儿科,200025

出　　处：《中华儿科杂志》2005年第2期93-95,共3页Chinese Journal of Pediatrics

摘　　要：目的　了解肥胖和超重儿童糖代谢及胰岛细胞功能状况。方法　对 52例单纯性肥胖与超重儿童进行口服糖耐量试验,并测定其血糖及胰岛素水平。计算胰岛素抵抗指数 (IR),胰岛素敏感指数(IS),服糖后 30min胰岛素增加值与血糖增加值的比值。并查甘油三酯、肝脏B超。体重指数(BMI)与IR之间、不同BMI组之间、糖耐量减低组与对照组之间进行比较。结果　发现糖尿病1例(1 9% ),IGT者 5例(9 6% )。IR≥2 8为胰岛素抵抗,占 76 9%。BMI与IR之间无相关关系。不同BMI组之间IR、IS、服糖后 30min胰岛素增加值与血糖增加值的比值差异均无统计学意义。糖耐量减低组与对照组之间IR、IS差异无统计学意义,服糖后 30min胰岛素增加值与血糖增加值的比值之间差异有统计学意义。甘油三酯升高 19例(37% ),脂肪肝 16例 (53% )。结论　肥胖与超重儿童普遍存在胰岛素抵抗和敏感性下降,其与BMI程度无关。肥胖伴糖耐量减低儿童除胰岛素抵抗外存在明显的B细胞功能减退。许多肥胖和超重儿童同时存在脂代谢紊乱。Objective To assess the state of glucose metabolism and beta-cell function in obese and overweight children.Methods Levels of glucose and insulin were detected during oral glucose toler ance test in 52 obese and overweight children aged 11.3±1.8 years with body m ass index (BMI) 30.2±19.2 kg/m2. Insulin resistance index (IR=FIN×FPG/22 .5), insulin sensitivity index (IS=1/FIN×FPG) and ratio of insulin increment t o glucose increment at 30’(I 30 -I 0/G 30 -G 0) post oral glucose wer e measured. (FIN=fasting insulin. FPG=fasting plasma glucose). The IR, IS and the ratio post oral glucose were compared among groups with varying BMI and bet ween groups of impaired glucose tolerance (IGT) and control. Serum triglyceride determination and B ultrasonography of liver were performed.Results (1)one patient with type 2 diabetes (1.9%) and 5 patients with IGT(9 .6%) were found. (2)IR(≥2.8) was observed in 76.9% of the cases.(3)The IR, IS and their ratio showed no difference between the compared groups.(4)IR and IS did not show significant difference but there was significant difference in r atio between the IGT and control group.(5)Increased serum triglyceride and fatt y liver were noted in 36.5% and 53.3% of the cases, respectively.Conclusion The results indicated that insulin resistance and reduced insulin sen sitivity in obese and overweight children are common, and these changes seemed n ot to correlated with the varying degree of BMI. β-cells function was obvious ly impaired in obese children with IGT and disorder of lipid metabolism exists i n many obese and overweight children revealed.

关 键 词：肥胖 超重儿童 糖耐量 胰岛素释放试验 糖尿病 

分 类 号：R725.8[医药卫生—儿科]