不同血糖水平人群胰岛素敏感性及β细胞功能分布  

Insulin sensibility and islets B cell function in different blood glucose levels

作　　者：邓宏明[1] 夏宁[1] 于志清[1] 肖常青[1] 李世生[1] 

机构地区：[1]广西医科大学代谢糖尿病研究中心,530021

出　　处：《中国糖尿病杂志》2001年第5期282-285,共4页Chinese Journal of Diabetes

摘　　要：目的　探讨超生理浓度的血浆葡萄糖对胰岛素分泌功能及外周组织胰岛素敏感性的作用。方法　 874例受试者根据 FBG、PBG水平 ,各分成 5组。FBG1:6 .11mmol/ L 以下 ;FBG2 :6 .11～ 6 .99mmol/ L;FBG3:7.0～ 7.77mmol/L;FBG4:7.78～ 11.10 mmol/ L;FBG5 :11.11mmol/ L 以上。 PBG分 5组。 PBG1:7.78mmol/ L 以下 ;PBG2 :7.78～11.10 mmol/ L ;PBG3:11.11～ 13.88mmol/ L ;PBG4:13.89～ 16 .6 6 mmol/ L ;PFG5 :16 .6 7mmol/ L以上。结果　 (1)随FBG升高 ,FINS水平逐渐升高 ,当 FBG>7.78mmol/ L后 ,FINS水平变化不明显 ,但未见高浓度 FBG抑制胰岛素分泌功能的现象。 (2 )随 PBG升高 ,PINS水平随之升高 ,当 PBG在 7.78～ 16 .6 7mmol/ L 范围内时 ,PINS浓度变化不明显 ,PBG>16 .6 7mmol/ L 后 ,PINS浓度随 PBG升高反而下降。 (3)高浓度葡萄糖抑制外周组织对胰岛素的敏感性 ,增加 IR,并抑制胰岛素分泌功能。相关分析表明 ,FBG与 HOMA- IR显著正相关 ,与 FINS/ FBG显著负相关。(4 )逐步回归分析表明 ,FINS水平主要决定于 HOMA- IR、FINS/ FBG,PINS水平主要决定于 FINS/ FBG、BMI、TG。结论　血浆葡萄糖对胰岛素分泌及其作用有三方面影响 :(1)低浓度葡萄糖刺激胰岛功能 ,增加胰岛素分泌 ;当血浆葡萄糖浓度在 7.Objective To study the effects of supraphysiologic concentration of plasma glucose on pancreatic islets secretion and peripheral tissue sensibility to insulin.Method 874 participants were divided into five groups by FBG or PBG respectively. FBG1:～6 10mmol/L;FBG2:6 11～6 99mmol/L;FBG3:7 0～7 77mmol/L;FBG4:7 78～11 10mmol/L;FBG5:11 11mmol/L～. PBG1:～7 77mmol/L;PBG2:7 78～11 10mmol/L;PBG3:11 11～13 88mmol/L;PBG4:13 89～16 66mmol/L;PBG5:16 67mmol/L～. Results (1) FINS were elevated gradually while FBG was elevating; FINS didn't changed significantly after FBG>7 78mmol/L, but supression of high concentration of FBG on pancreatic islets secretion was not revealed.(2)PINS were elevated with PBG; when PBG was in range of 7 78～16 67mmol/L PINS didn't changed significantly, but PINS decreased significantly after PBG>16 67mmol/L. (3) High concentration of glucose supressed the sensibility of peripheral tissues to insulin and pancreatic islets secretic function. Correlation analysis showed that FBG correlated with IR positively and FINS/FBG negatively. (4) Stepwise regression analysis showed that plasma insulin were decided mainly by FINS/FBG?HOMA IR?BMI.Conclusion Plasma glucose has three effects on insulin secretion and function. (1) Low concentration of glucose stimulates pancreatic islets secretion and increases plasma insulin concentration; when plasma glucose concentration is in the range of 7 78～16 67mmol/L, plasma insulin concentration doesn't changed significantly; plasma insulin concentration decreases significantly after plasma glucose>16 67mmol/L. (2) Plasma insulin concentration is decided mainly by FINS/FBG?HOMA IR?BMI.

关 键 词：葡萄糖毒性 胰岛素抵抗 胰岛素分泌 糖尿病 

分 类 号：R587.1[医药卫生—内分泌]