代谢综合征人群的胰岛素抵抗及胰岛β细胞功能  

Insulin resistance and β-cell function of subjects with Metabolic Syndrome

作　　者：龚莉琳[1] 张素华[1] 任伟[1] 李蓉[1] 李启富[1] 唐晓君[2] 汪志红[1] 张闻宇[1] 白晓苏[1] 

机构地区：[1]重庆医科大学附属第一医院内分泌科,重庆400016 [2]重庆医科大学流行病学教研室,重庆400016

出　　处：《重庆医科大学学报》2007年第2期129-133,共5页Journal of Chongqing Medical University

基　　金：重庆市卫生局医学科学基金资助(2000-2027)

摘　　要：目的:探讨代谢综合征(MS)人群胰岛素抵抗(IR)的检出率以及伴与不伴IR的MS人群间临床特征和胰岛β细胞功能的差别。方法:采用随机整群分层抽样对重庆地区20岁以上人群进行横断面流行病学调查,所有调查对象均测量人体测量学指标,进行75g口服葡萄糖耐量试验,测定血糖、血脂、胰岛素等。选取资料完整者共2323例列入本次分析。用Homa-IR评估胰岛素抵抗,Homa-β和处置指数(DI)评估胰岛β细胞功能。结果:(1)以IDF定义所诊断的MS患病总人数为482人(患病率20.77%),其中伴IR者占60.17%,不伴IR者占39.83%。(2)与MS不伴IR者相比,伴IR者的体重指数、空腹血糖、餐后2h血糖、舒张压、血浆甘油三酯水平均明显增加,差别具显著性(P<0.05)。⑶与正常对照组(98.60±56.18)比较,DI值在MS不伴IR组(57.49±30.62)、MS伴IR组(39.69±29.35)依次降低,3组间两两比较差别均具显著性意义(P<0.01)。(4)与正常对照组比较,DI值在糖耐量正常的MS不伴IR组(66.49±30.06)、高血糖的MS不伴IR组(45.14±26.98)依次降低,3组间两两比较差别均具显著性意义(P<0.01)。结论:并非所有MS患者均伴IR,不伴IR的MS患者合并代谢紊乱的成份较少、程度较轻。无论伴或不伴IR,MS患者均存在胰岛β细胞功能减退。Objective：To calculate prevalence of insulin resistance （IR） among individuals who met the criteria for Metabolic Syndrome （MS） of International Diabetes Federation （IDF） definition and to investigate clinical characteristics and β-cell function in patients of MS with or without IR.Methods：Random stratified sampling method was applied to the cross-sectional epidemiology survey on subjects aged 20years and over in Chongqing district. For all subjects,somatometry parameters were tested,75gram oral glucose tolerance tests were conducted,and some other parameters were also detected, like blood glucose, lipid-profile and insulin.Data of 2323 subjects with complete laboratory data were gathered for analysis.Homeostasis model assessment of insulin resistance（Homa-IR） was used to estimate insulin resistance,and Homa-β and disposition index（DI） to evaluate β-cell function. Results： （1）MS was presented in 482 individuals （20.77%）,diagnosed according to the definition proposed by IDF in 2005. In those subjects with MS,there were 290 individuals （60.17%） with IR and 192 individuals （39.83%） without IR. （2）The MS without IR group had lower body mass index,fasting and 2h post-load plasma glucose, diastolic blood pressure and triglyceride than the MS with IR group, and the difference was significant （P〈0.05）.（3）Compared with control subjects（98.60±56.18）,DI of MS with and without IR groups both significantly decreased（respectively 39.69±29.35 and 57.49±30.62）,and the differences between every two of them were significant（P〈0.01）. （4）DI of control subjects, normal glucose tolerance subjects of MS without IR group （66.49±30.06） and hyperglycemic patients of MS without IR group （45.14± 26.98）decreased in order,and the differences between every two of them were also significant （P〈0.01）. Conclusion.Not all individuals with MS presented IR. The state of metabolic disturbance was less serious in subjects of MS without IR.No matter with or

关 键 词：代谢综合征 胰岛素抵抗 胰岛Β细胞功能 

分 类 号：R587.1[医药卫生—内分泌]