内源性高甘油三酯血症存在胰岛素抵抗  

Insulin Resistance is Associated with Lipid and Apolipoprotein Abnormalities in Endogenous Hypertriglyceridemia

作　　者：范萍[1] 刘秉文[1] 方定志[1] 张荣爵[1] 刘宇[1] 傅明德[1] 

机构地区：[1]华西医科大学生物化学与分子生物学研究所载脂蛋白研究室

出　　处：《中国动脉硬化杂志》1996年第2期104-107,共4页Chinese Journal of Arteriosclerosis

基　　金：卫生部科研基金

摘　　要：为探讨内源性高甘油三酯血症是否存在胰岛素抵抗，本文对５３例内源性高甘油三酯血症患者及３３例年龄及性别相匹配的正常人的耐糖试验、胰岛素分泌试验、空腹血脂及血浆载脂蛋白进行了分析。结果发现，内源性高甘油三酯血症患者口服１００ｇ葡萄糖后血糖及血浆胰岛素水平明显增加，服糖后２ｈ血糖大于７．２２ｍｍｏｌ／Ｌ，服糖后３ｈ血浆胰岛素仍未恢复至空腹水平；且血浆胰岛素面积和葡萄糖面积、血浆胰岛素面积与葡萄糖面积的百分比及胰岛素抵抗指数均明显高于正常对照组，说明内源性高甘油三酯血症患者存在胰岛素抵抗，出现高胰岛素血症及葡萄糖耐量降低。Aim To understand whether abnormality of lipoprotein in endogenous hypertriglyceridemia (HTG) is associated with insulin resistance, we studied oral glucose tolerance test, insulin secretion, plasma triglyceride (TG) , total cholesterol (TC) , high density lipoprotein cholesterol (HDLC) ,low density lipoprotein cholesterol (LDLC) , apolipoprotein (apo) A Ⅰ ,A Ⅱ ,B100, CⅢ,C Ⅲ and E levels in 53 endogenous HTG patients whose plasma TG levels were ≥2. 26 mmol/L, TC<6. 21mmol/L, and in 33 normal subjects whose plasma lipid levels were normal (TG<2. 26 mmol/L, TC<6. 21mmol/L ).Methods Oral glucose tolerance test and insulin release test were performed by routine methods. Plasma glucose and lipids were determined by enzyme method.Plasma apolipoproteins and insulin were determined respectively by radial immunodiffusion (RID) assay and radio-immunoassay (RIA). Insulin resistance and β-cell function were analysised according to patient's fasting plasma insulin and glucose concentration by Mathews's method.Results The results indicated that the fasting plas ma TG, apo C Ⅱ, CⅢ and E levels were significantlyhigher and HDLC level was lower in the endogenous HTG group than those in the control group (P<0.01). The fasting plasma insulin and glucose levels were normal , but the plasma glucose and insulin levels after glucose loading were increased (P<0.05) and the plasma glucose level at 120 minutes after oral glucose was>7. 22 mmol/L , and the plasma insulin level at 180 minutes after oral glucase was much higher than that in the fasting state (P< 0. 001 ) in the endogenous HTG,while the plasma glucose, the plasma insulin area , the ratio of insulin area to glucose area and the insulin resistance were also increatal in the endogenous HTG group (PM0. 05 ) .Conclusions The results above suggest that the glucose intolerance, the insulin resistance and the hyperinsulinemia existed in the endogenous HTG.

关 键 词：内源性 高甘油三酯血症 胰岛素抵抗 

分 类 号：R589.202[医药卫生—内分泌]