不同类型血脂紊乱对初诊2型糖尿病患者胰岛素抵抗和胰岛功能的影响  

Effect of Various Kind of Dyslipidaemia on Insulin Resistance and Pancreatic Islet Function in Newly Diagnosed Type 2 Diabetic Patients

作　　者：张研[1] 袁莉[1] 周慜[1] 

机构地区：[1]华中科技大学附属协和医院内分泌科,湖北武汉430000

出　　处：《中国医师杂志》2005年第7期892-895,共4页Journal of Chinese Physician

摘　　要：目的比较不同类型的血脂紊乱对初诊2型糖尿病患者胰岛素抵抗程度和胰岛β细胞分泌功能的影响。方法263例初诊的2型糖尿病患者,按美国ATPIII标准分为血脂正常组和血脂异常组。后组又分为三个亚组:高甘油三酯组、高胆固醇组、混合型高脂血症组。用稳态模型评估法评价胰岛素抵抗及胰岛β细胞功能,并计算胰岛素早期分泌指数(EISI)和OGTT各时点胰岛素曲线下面积(AUCI)。结果263例2型糖尿病患者中血脂紊乱发生率为63%。高甘油三酯组和混合组BMI,WHR高于正常组(P<0.01或P<0.05)。高甘油三酯组的空腹胰岛素,空腹C肽,HOMA-IR,EISI较正常组显著升高(P<0.01,P<0.05),胰岛素敏感性指数(IAI)较其他各组低(P<0.05)。各组HOMA-β,AUCI无显著差别。结论2型糖尿病患者脂代谢紊乱类型以高TG血症最常见。血TG增高加重糖尿病患者胰岛素抵抗和胰岛素分泌负担。高TG血症反映了糖尿病患者胰岛素抵抗的程度。Objective To evaluate the effect of various kinds of dyslipidaemia on insulin resistance and pancreatic islet β cell function in newly diagnosed type 2 diabetic patients. Methods 263 patients with newly diagnosed type 2 diabetes were divided into normal lipidemia group and dyslipidaemia group according to ATPⅢ standard. The dyslipidaemia group included 3 subgroups as the following: high TG group, high TC group, and mix group with high TG and TC. Homeostasis model assessment (HOMA) was applied to estimate insulin resistance (IR) and pancreatic islet β cell function. Early insulin secretion index (EISI) and area under curve of insulin (AUCI) at all OGTT time points were calculated. Results Incidence of dyslipidaemia in the type 2 diabetic patients was 63%. BMI and WHR were significantly higher in both high TG group and mix group than in normal lipidemia group(P<0.01 or P<0.05).FINS, fasting serum C peptide, HOMA-IR and EISI significantly increased in high TG group as compared with normal lipidemia group(P<0.01 or P<0.05), and IAI was significantly lower than that in the other groups(P<0.05). HOMA-β and AUCI were not significantly different among all groups. Conclusion Hypertriglyceridemia was most common in type 2 diabetic patients. High triglyceride increased insulin resistance and insulin secretion burden. Hypertriglyceridemia could reflect the degree of insulin resistance in type 2 diabetic patients.

关 键 词：2型糖尿病 血脂紊乱 胰岛Β细胞功能 胰岛素抵抗 

分 类 号：R587.1[医药卫生—内分泌]