糖耐量正常者胰岛素敏感性和β细胞功能的研究  

An Investigation of Insulin Sensitivity and β Cell Function of Persons with Normal Glucose Tolerance

作　　者：金京姬[1] 许玉子[1] 孙明子[1] 

机构地区：[1]延边大学附属医院内四护理单元,吉林省延吉市133000

出　　处：《中国全科医学》2011年第35期4101-4103,共3页Chinese General Practice

摘　　要：目的探讨糖耐量正常(NGT)者胰岛素抵抗(IR)和胰岛素的分泌功能。方法根据胰岛素曲线下面积(AUCins)水平,将73例NGT者分为A、B两组,其中A组55例,AUCins<100 U/L;B组18例,AUCins≥100U/L。应用胰岛素分泌指数(ΔI30/ΔG30)和Homaβ细胞功能指数(HOMA-β)评价β细胞功能,Homa胰岛素抵抗指数(HOMA-IR)和胰岛素敏感指数(ISI)评估IR,高胰岛素-正常葡萄糖钳夹技术评估A组和B组各6例葡萄糖利用率(M)。结果 B组空腹血糖(FPG)、血糖曲线下面积(AUCpg)与A组比较,差异无统计学意义(P>0.05);而空腹胰岛素(FINS)、AUCins增多(P<0.01)。B组ΔI30/ΔG30及HOMA-β较A组增加(P<0.01),HOMA-IR亦增加(P<0.01),IAI降低,差异均有统计学意义(P<0.01)。B组6例M(7.3±0.4)mg.kg-1.min-1较A组6例M(9.5±0.5)mg.kg-1.min-1降低,差异有统计学意义(P<0.01)。结论 NGT人群中部分已经存在明显的IR和β细胞功能代偿性分泌增加,2型糖尿病(T2DM)的预防工作应从NGT期开始。Objective To investigate insulin sensitivity and insulin secretion of persons with normal glucose tolerance. Methods 73 subjects of NGT in OGIRT were divided into two groups （ Group A, AUCins 〈 100 U/L vs Group B AUCins≥100 U/L） . β cell function was determined by Insulin secretion index （ △I30/△G30） and HOMA -β cell function index （HOMA - β）. IR was determined by Insulin resistance index （ HOMA - IR） and Insulin sensitivity index （ HOMA - IR）. Hypefinsulinemic euglycemic clamp was applied to 6 cases in group A and group B respectively to grade the Glucose utilization （M）. Results In terms of FPG and AUCpg, there is no significant difference between group A and group B （ P 〉 0. 05 ） ; The secretion of FINS and AUCins in group B were increaseda （P 〈 0. 01 ）. △I30/△G30 and HOMA - β in group B were increased as well as HOMA - IR than those in group A, but with a drop in IAI （ P 〈0. 01 ）. During the steady - state of the hyperinsulinemic euglycemic clamp, the insulin - mediated glucose disappearance rate was significantly decreased in group B （ 7. 3 ± 0. 4 ） mg·kg^-1·min^-1 compared with group A [（9. 5 ± 0. 5 ）mg·kg^-1· min^-1 （ p 〈 0. 01 ） ]. Conclusion The insulin resistance is existed and the functional compensatory secretion of β- cell within the NGT groups have been increased compared with healthy groups. The precaution work against T2DM type should be taken right now just from NGT period.

关 键 词：正常糖耐量 胰岛Β细胞分泌功能 胰岛素抵抗 口服葡萄糖-胰岛素释放试验 高胰岛素-正常葡萄糖钳夹技术 

分 类 号：R587.1[医药卫生—内分泌]