肥胖儿童糖负荷后2小时血糖与胰岛β细胞功能和血脂关系的研究  

Study on the Relationship between Levels of 2 h-PG and Changes of Islet β Cell Function and Blood Lipid in Obese Children

作　　者：王燕利[1] 刘戈力[1] 杨箐岩[1] 郑荣秀[1] 姜丽红[1] 李岩[1] 李亚璞[1] 鲍鹏丽[1] 

机构地区：[1]天津医科大学总医院儿科,300052

出　　处：《天津医药》2013年第2期101-104,共4页Tianjin Medical Journal

基　　金：十一五国家科技支撑计划项目"代谢综合征稿早期识别和干预技术研究"(项目编号:2009BAI80B00)

摘　　要：目的探讨肥胖儿童糖负荷后2h血糖（2h-PG）与胰岛B细胞功能和血脂的相关性。方法收集9-15岁肥胖儿童102例，空腹血糖（FPG）均〈5．6mmol／L，根据2h-PG分为G1组（2h-PG≤5．6mmol／L）、G2组（5．7-7．7mmol／L）和G3组（2h-PG≥7．8mmol／L）。比较各组之间糖脂代谢指标的差异及各指标与2h-PG的相关关系。结果G1组糖化血红蛋白（HAblc）、FPG低于G2、G3组。G3组空腹胰岛素（FINS）、0．5h胰岛素（0．5h-INS）、胰岛素抵抗指数（HOMA-IR）高于G1、G2组。G3组高密度脂蛋白胆固醇（HDL-e）低于G1组。3组问0．5h糖负荷后血糖（0．5h-PG）、2h糖负荷后胰岛素（2h-INS）、低密度脂蛋白胆固醇（LDL-c）、经胰岛素抵抗校正的早期胰岛素分泌指数（IR-EIS）差异均有统计学意义（P〈O．05或P〈0．01）。扣除年龄和体质量指数（BMI）的影响，2h-PG与HAblc、FPG、0．5h-PG、0．5h-INS、2h-INS、HOMA-IR、LDL-c呈正相关（P〈0．05或P〈0．01），与IR-EIS呈负相关（P=0．002）。多重线性回归分析显示2h-INS、FPG、FINS、IR-EIS是2h-PG的影响因素。结论肥胖儿童2h-PG〉5．6mmol／L时已出现早期胰岛B细胞功能下降及血脂异常。Objective To investigate the relationship between the 2 h plasma glucose level after oral glucose toler- ance tests （2h-PG） and islet 13-cell function and blood lipid in obese children. Methods A total of 102 obese children aged 9-15 years were enrolled in this trial. Levels of fasting plasma glucose （FPG） in children were all lower than 5.6 mmol/L. Ac- cording to 2 h-PG, subjects were divided into G1 （2 h-PG≤5.6 mmol/L） group, G2 （5.7-7.7 mmol/L） group and G3 （2 h-PG ≥ 7.8 mmol/L） group. The parameters related to glucose and lipid metabolism were compared between groups. The re- lationship between 2 h-PG and all indexes were analyzed. Results Levels of glyeosylated hemoglobin （HbAle） and FPG were significantly lower in G1 group than those in G2 group and G3 group. Levels of fasting insulin （FINS）, 0.5 insulin （0.5 h-INS） and insulin resistance index （HOMA-IR） were significantly higher in G3 group than those in G1 and G2 groups. The level of high-density lipoprotein cholesterol （HDL-c）was significantly lower in G3 group than that in G1 group. There were significant differences in 0.5 plasma glucose after oral glucose tolerance tests （0.5 h-PG）, 2-hour insulin after oral glucose tolerance tests（2h-INS）, low density lipoprotein cholesterol （LDL-c） and early insulin secretion index corrected by insulin re- sistance （IR-EIS） between three groups （P 〈 0.05 or P 〈 0.01）. The level of 2 h-PG was positively related with HAblc, FPG, 0.5 h-PG, 0.5 h-INS, 2 h-INS, HOMA-IR and LDL-c （P 〈 0.05 or P 〈 0.01）, hut 2 h-PG was negatively related with IR-EIS （P = 0.002） after deduction of the effects of age and BMI. Multiple linear regression analysis showed that 2h-INS, FPG, FINS and IR-EIS were influencing factors of 2 h-PG. Conclusion When 2 h-PG is higher than 5.6 mmol/L in obese children, there has been early islet 13-cell function decline and dyslipidemias.

关 键 词：肥胖症 胰岛素抗药性 血红蛋白A 糖基化 葡糖耐量试验 血脂异常 儿童 糖负荷后2 h血糖 胰岛β 细胞功能 

分 类 号：R587.1[医药卫生—内分泌]