2型糖尿病家系非糖尿病一级亲属胰岛素抵抗与胰岛β细胞功能变化5年随访研究  

Study of Insulin Resistance and β-cell Function in First-degree Relatives of Type 2 Diabetes during 5 Years Follow-up

作　　者：王芳[1] 刘军[1] 陈灶萍[1] 查兵兵[1] 查英[1] 丁和远[1] 盛励[1] 廖晓寰[2] 

机构地区：[1]复旦大学附属上海市第五人民医院内分泌科,上海200240 [2]复旦大学附属上海市第五人民医院检验科,上海200240

出　　处：《中国临床医学》2009年第2期232-234,共3页Chinese Journal of Clinical Medicine

摘　　要：目的:探讨随访2型糖尿病(T2DM)家系非糖尿病一级亲属5年的胰岛素抵抗和胰岛β细胞功能变化。方法:入选2型糖尿病家系非糖尿病一级亲属组(FDR)32例和正常对照组(NC)18例,基线检测了体质量指数、腰臀比、血压、血脂、血糖和空腹胰岛素(FINS)水平。采用稳态模式(HOMA)评价胰岛素抵抗(HOMA-IR)和胰岛β细胞功能(HOMA-β),5年后进行了相同的随访。结果:5年后FDR组HOMA-IR明显升高(P=0.040),HOMA-β明显降低(P=0.004)。5年后FDR组与NC组HOMA-IR组间无显著差异(P=0.594),HOMA-β明显降低(P=0.000)。多元逐步回归分析显示,FINS、空腹血糖(FBG)、高密度脂蛋白-胆固醇(HDL-C)是影响FDR组胰岛素抵抗的独立危险因素;FBG和FINS是影响FDR组胰岛β细胞功能的独立危险因素。结论:T2DM患者一级亲属非肥胖患者在发生糖尿病之前已经存在胰岛素抵抗和胰岛分泌功能缺陷,且随着病程延长胰岛β细胞功能衰竭可能更明显。Objective：To investigate insulin resistance and the β-cell function in nondiabetic first degree relatives of type 2 diabetes mellitus（FDR） over 5 years follow-up. Methods：Thirty-two patients with non-diabetic first degree relatives of type 2 diabetes（FDR） and 18 healthy controls（NC）were assigned and measuerd body mass index（BMI）, waist hip ratio（WHR）, blood pressure, serum lipids, serum glucose and fasting insulin（FINS） at baseline. Homeostasis model assessment（HOMA） was applied to assess the status of insulin resistance and β-cell function. Five years later, all subjects were reexamined. Results：HOMA-IR was significantly elevated and HOMA-β was lower in FDR group compared with baseline. During 5 years follow-up, HOMA-IR was not significantly changed between two the groups, but HOMA-β was significantly lower in FDR group than in NC group. Multiple linear regression analysis showed that FBG, FINS,HDL-C were the major risk factors affecting insulin resistance in FDR and the major risk factors affecting β-cell function was FBG and FINS. Conclusion：The nonobese first degree relatives of type 2 diabetes mellitus had insulin resistance and impaired β-cell function at prediabetic stage, and by step, β-cell function may be significantly lower in the period of developing type 2 diabetes mellitus.

关 键 词：2型糖尿病 胰岛素抵抗 胰岛Β细胞功能 

分 类 号：R587.1[医药卫生—内分泌]