中老年正常糖耐量人群胰岛β细胞功能分析  

Islet β-cell function in subjects with normal glucose tolerance at above 30 years of age

作　　者：葛军[1] 俞春芳[1] 许其伎[1] 金立刚[1] 王希淳[1] 陈允硕[1] 吴敏生[1] 刘钧钧 刘文斌 王宝珍[4] 史京衡[4] 史虹莉[5] 

机构地区：[1]上海市东医院内分泌科,200438 [2]上海市杨浦区江浦医院 [3]上海市杨浦区五角场医院 [4]上海市杨浦区卫生局 [5]上海市复旦大学附属华山医院内分泌科

出　　处：《中华老年医学杂志》2010年第3期250-252,共3页Chinese Journal of Geriatrics

摘　　要：目的分析中老年正常糖耐量人群血糖水平与胰岛B细胞分泌功能的关系。方法选择上海市部分社区流行病学调研2095例居民，根据口服葡萄糖耐量试验（OGTT）、空腹血糖（FPG）和餐后2h血糖（2hPG）结果，将受检者分为正常糖耐量、糖耐量减低（IGT）、空腹血糖受损（IFG）、糖耐量减低合并空腹血糖受损（IFG／IGT）及糖尿病组，再将正常糖耐量者按年龄及空腹血糖值进行分组，观察稳态胰岛B细胞功能指数（HBCI），并对各组年龄、血糖与胰岛口细胞分泌功能指标进行统计学分析。结果（1）随着年龄的增长，FPG逐渐升高，40～49岁、50～59岁及60～69岁组分别为（5．00±0．47）mmol／L、（5．09±0．44）mmol／L及（5．17±0．48）mmol／L，50～59岁组与40～49岁组比较（t=2．727，P〈0．01）、60～69岁组与50～59岁组比较（t=2．303，P〈0．05），均差异有统计学意义，但空腹胰岛素（FINS）值变化无明显规律；（2）随着年龄的增长，HBCI值呈下降趋势（F=33．75，P〈0．05）；（3）FPG≥5．0mmol／L组较〈5．0mmol／L组HBCI值下降，分别为4．39±0．58和4．22±0．70，差异有统计学意义（t=2．974，P〈0．05）。结论中老年正常糖耐量者随着年龄增长，空腹血糖增高；当空腹血糖≥5．0mmol／L时，可能存在胰岛B细胞分泌功能异常。Objective To investigate the relationship between fasting plasma glucose （FPG） level and insulin secretion in normal glucose tolerance （NGT） subjects. Methods Totally a community-based population of 2095 residences aged above 30 years received oral glucose tolerance test （OGTT）, and was classified according to FPG and 2-hour plasma glucose （2 hPG） into NGT group, impaired glucose tolerance （IGT） group, impaired fasting glucose （IFG） group, both IGT and IFG （IFG/IGT） group and diabetes mellitus （DM） group. The subjects in NGT group were further divided into 6 groups according to age and FPG separately, the HOMA β-cell function index （HBCI） was compared among the groups. Results For the patients in NGT group, the FPG level was higher in group aged 60-69 years than in group aged 50-59 years [（5.17±0.48）mmol/L vs. （5.09±0.44）retool/L, P〈0. 053, and was also higher in group aged 50-59 years than in group aged 40-49 years [（5.09± 0.44） mmol/L vs. （5.00 ±0.47） mmol/L, P〈0. 013 ]. A decreasing tendency of HOMA-β and fasting insulin level with age could be observed with statistical significance. The HBCI was lower in NGT group with FPG above 5.0 mmol/L than with FPG below 5.0 mmol/L （4.22± 0.70 vs. 4.39±0.58, P〈0.05）. HBCI was negatively correlated with age as the main factor. Conclusions In NGT subjects, the FPG increases with age and there may be abnormality of insulin secretion in subjects with FPG higher than 5.0 mmol/L.

关 键 词：葡萄糖耐量试验 胰岛素分泌细胞 

分 类 号：R587.1[医药卫生—内分泌]