不同糖代谢痛风患者β细胞功能及代谢特征分析  

Function of islet β cell and metabolic features in gout patients with different status of glucose metabolism

作　　者：彭彩碧[1] 徐焱成[1] 李雪锋[2] 胡清[2] 

机构地区：[1]武汉大学中南医院内分泌科,430071 [2]郧阳医学院附属太和医院内分泌科

出　　处：《中华内分泌代谢杂志》2010年第9期767-769,共3页Chinese Journal of Endocrinology and Metabolism

摘　　要：目的 探讨痛风患者从正常糖耐量（NGT）到糖尿病不同糖代谢状态时的胰岛素抵抗与胰岛β细胞功能的演变,分析痛风合并糖代谢紊乱患者的代谢特征.方法 96例痛风患者分为糖耐量正常（NGT）组（n=35）、糖调节受损（IGR）组（n=27）及糖尿病组（n=34）.测量身高、体重、血压,测定空腹血糖、空腹胰岛素、HbA1C、血清尿酸、总胆固醇、甘油三酯及C反应蛋白（CRP）,计算体重指数（BMI）、稳态模型评估的胰岛素抵抗指数（HOMA-IR）、稳态模型评估的胰岛β细胞功能指数（HOMA-B）和胰岛素敏感指数（ISI）.结果 糖尿病组和IGR组的BMI、餐后2h血糖（2hPG）、空腹胰岛素、HbA1C、总胆固醇、甘油三酯、CRP、HOMA-IR均高于NGT组（P〈0.05或P〈0.01）,而糖尿病组及IGR组ISI均低于NGT组（0.023±0.018和0.024±0.017对0.052±0.026,P〈0.05）.NGT组、IGR组和糖尿病组HOMA-B差异有统计学意义（87.6±25.1、126.46±34.2及173.75±32.1,P〈0.05）.糖尿病组糖尿病家族史阳性率高于NGT组（41.17%对11.4%,P〈0.05）.logistic回归分析显示,年龄、BMI、收缩压、甘油三酯、CRP、ISI与糖尿病独立相关,而尿酸与糖尿病无相关性.结论 重度胰岛素抵抗、胰岛β细胞分泌功能障碍、BMI增加、C反应蛋白水平增高、脂代谢异常、遗传易感性是痛风患者合并糖尿病的主要代谢特征.Objective To investigate the changes of insulin resistance and islet β cell function in gout patients with different status of glucose metabolism, and to analyse metabolic features in gout patients with hyperglycemia. Methods Ninety-six patients with gout were consecutively enrolled into the study and were divided into normal glucose tolerance group （ NGT, n = 35 ） , impaired glucose regulation group （ IGR, n = 27 ） , and diabetic group （DM, n=34）. Height, weight, blood pressure, fasting plasma glucose, fasting insulin, HbA1C,serum uric acid, C-reactive protein （CRP）, total cholesterol （TC）, and triglycerides were determined in all subjects. Body mass index （BMI）, homeostasis model assessment for insulin resistance index （HOMA-IR）,homeostasis model assessment for β cell function index （HOMA-B）, and insulin sensitivity index （ISI） were calculated. Results Compared with the NGT group, the levels of BMI, 2hPG, fasting insulin, HbA1C,TC,triglycerides, CRP, HOMA-IR in the DM and IGR groups were higher while ISI was lower （0.023±0.018 and 0.024±0.017 vs 0. 052±0. 026, P〈0.05 ）. HOMA-B was significantly different among the three groups （ 87.6±25. 1,126.46±34. 2, and 173.75±32.1, P〈0.05）. Family history of diabetes was more commonly seen in DM group than NGT group （ 41.17% vs 11.4%, P〈 0.05 ）. Logistic analysis showed that age, BMI, systolic blood pres（s）ure, triglyceride, CRP, and ISI were independently associated with diabetes, but not with uric acid.Conclusions Severe insulin resistance, β cell dysfunction, increased BMI and CRP, lipid disorders, and hereditary susceptibility may be the main metabolic features of gout patients with hyperglycemia.

关 键 词：痛风 胰岛素抵抗 Β细胞功能 糖代谢 C反应蛋白 

分 类 号：R587.1[医药卫生—内分泌]