用葡萄糖钳夹技术评价各种简易胰岛素抵抗指数计算公式  

Evaluating the simple indices of insulin resistance with hyperinsulin-euglycemic clamp

作　　者：厉平[1] 李玲[1] 刘聪[1] 王艳军[1] 吴波[1] 岳桂英[1] 

机构地区：[1]中国医科大学附属第二医院内分泌科,沈阳110004

出　　处：《中国糖尿病杂志》2007年第12期708-710,共3页Chinese Journal of Diabetes

摘　　要：目的探讨以金标准正糖钳夹技术评价各种简易胰岛素抵抗指数计算公式的准确性。方法选取糖耐量正常(NGT)者14例,IGT者23例,T2DM者8例,以钳夹技术及各简易胰岛素抵抗指数计算公式(1/FIns,FPG/FIns,HOMA-IR,IAI,QUICKI)测定IR程度,以钳夹技术试验结果葡萄糖输注速率(GIR)为评价标准,对各个指数进行评价。结果QUICKI、IAI、HOMA-IR、FIns在NGT组和IGT组中与GIR显著相关,在T2DM组不相关。与GIR的相关程度以QUICKI、IAI最强、HOMA-IR及1/FIns次之。FPG/FIns与GIR无明显相关。结论在NGT和IGT人群中,QUICKI、IAI、HOMA-IR和1/FIns能够比较准确地评估IR程度;但在Ins分泌严重缺陷的T2DM人群中,应用则受到限制。Objective To evaluate whether the simple indices of insulin resistance are reliable for the Chinese individuals with different glucose tolerance states. Methods A total of 45 subjects （25 men and 20 women, aged 19-75 years, BMI 18-44 kg/m^2 ） were enrolled, including normal glucose tolerance （NGT, n= 14）, impaired glucose tolerance （IGT, n=23）, and type 2 diabetes mellitus （T2DM, n=8）. All the subjects underwent a hyperinsulin-euglycemic clamp to evaluate their insulin resistance. Five simple indices of insulin resistance derived from the fasting glucose and insulin levels were calculated and compared with glucose infusion rate （GIR） of the clamp. Results QUICKI, IAI, HOMA-IR and Fins were highly correlated with GIR in the NGT group （r=0.70, P=0.006; r=0.71, P=0.005;r=-0.62, P=0.018; r=-0.69, P= 0. 006 ） and in IGT group （r=0. 79, P=0. 000; r=0. 78, P=0. 000; r=-0. 65, P=0. 001; r=-0. 60, P=0. 002）, but not correlated with GIR in the DM group （r=-0. 47, P=0. 318; r=-0. 47, P=0. 318; r= -0.42, P=0. 279; r= -0. 19, P=0. 658）. The calculated indices that correlated most strongly with GIR were QUICKI and IAI. The correlation between HOMA-IR and GIR was relatively weak, but was even stronger than that of GIR with Fins and FPG/FIns. Conclusions QUICKI, IAI, HOMA-IR and Fins are reliable indices of insulin resistance for the NGT and IGT individuals who have enough insulin secretion to compensate for the insulin resistance. But for the DM patients whose beta-cell dysfunction is serious, these indices are unreliable.

关 键 词：糖尿病 2型 胰岛素抵抗 葡萄糖钳制技术 

分 类 号：R587[医药卫生—内分泌]