正常糖代谢肥胖女性体成分改变及β细胞功能分析  

Association of body composition and β-cell function in obese females with normal glucose metabolism

作　　者：严孙杰[1] 沈喜妹[1] 颜晓芳[1] 易如海[1] 吴佩文[1] 杨立勇[1] 张松菁[1] 

机构地区：[1]福建医科大学附属第一医学院内分泌科,福州350005

出　　处：《中华内分泌代谢杂志》2009年第1期52-55,共4页Chinese Journal of Endocrinology and Metabolism

基　　金：福建省教育厅科技项目（JA05263）

摘　　要：目的了解无糖尿病家族史、正常糖代谢肥胖女性体成分改变及胰岛β细胞功能变化。方法双能X线骨密度仪（DXEA）检测75名入选对象体成分，并行静脉葡萄糖耐量试验（IVGTT），按体重指数（BMI）水平分为4组。以胰岛素曲线下面积（AUCins）、胰岛素急性时相分泌（AIR）、稳态模型β细胞功能指数（HOMA2-％B）评估β细胞功能，以胰岛素抵抗指数（HOMA2-IR）、胰岛素曲线下面积／血糖曲线下面积（AUCins／AUCglu）评估胰岛素抵抗情况。结果随着BMI增加，入选对象总体脂含量、躯干脂含量均呈递增趋势，以躯干脂增加为主；IVGTF 0和10min血糖、AUCins、AIR、AUCins／AUCglu、10min与0min胰岛素差值[INS（10-0）]亦呈递增趋势。AIR、AUCins、Aucins／Aucglu、INS（10-0）与年龄、BMI、总体脂含量、躯干脂含量均相关；控制年龄因素后，躯干脂含量始终与AIR呈独立相关；且两者具有良好线性关系。结论肥胖女性存在以躯干脂增加为主的体成分改变和伴胰岛素抵抗的β细胞代偿性分泌增加。与BMI、腰围相比，体脂成分分析更能预测肥胖患者早期β细胞功能受损。Objective To explore the relationship between body composition and β-cell function in obese females with normal glucose metabolism. Methods Seventy-five obese women with normal blood glucose and without family history of diabetes were investigated. They were assigned to 4 groups based on body mass index （BMI）. Body fat content was measured by dual-energy X-ray absorptiometry （DEXA）, and intravenous glucose tolerance test （IVGTT） was performed. The acute insulin response （AIR） , the area under the curve （AUC） of insulin （AUCins） and homeostasis model assessment （HOMA） for β-cell function （HOMA2-% B ）were calculated. Insulin resistance index（HOMA2-IR） and the ratio of AUCins to AUC of glucose （AUCins/AUCglu） were calculated to assess insulin resistance. Results Women with higher BMI appeared to have more total body fat content and trunk fat content. The similar distribution was also found in other parameters, including the plasma glucose levels at 0 and 10 min, AUCins, AIR, AUCins/AUCglu and the difference of insulin level between 0 and 10 min [ INS （10-0） ] during IVG3T. AUCins, AIR, AUCins/AUCglu and [ INS （10-0） 1 were positively correlated with the age, BMI,total body fat content and trunk fat content. After adjustment of age, the trunk fat content was independently associated with the AIR in a good linear manner. Conclusion The obese females show change in body composition with more trunk fat content. They show significant insulin resistance with compensated elevation of insulin secretion. Body composition assessment is a valid and more accurate method than BMI and waist circumference in predicting early damaged β-cell function in obese patients.

关 键 词：肥胖症 体脂 胰岛Β细胞功能 胰岛素抵抗 

分 类 号：R686[医药卫生—骨科学]