2型糖尿病患者非糖尿病一级亲属胰岛素抵抗与脂代谢紊乱  

Insulin resistance and dyslipidemia in nondiabetic first-degree relatives of type 2 diabetes

作　　者：胡云[1] 朱大龙[1] 韩光晓[1] 林凌[1] 黄群[1] 冯雪风[1] 张扬[1] 

机构地区：[1]南京大学医学院附属鼓楼医院内分泌科,210008

出　　处：《江苏医药》2002年第3期176-178,共3页Jiangsu Medical Journal

摘　　要：目的　探讨 2型糖尿病患者非糖尿病一级亲属 (简称一级亲属 )胰岛素抵抗及其脂代谢紊乱。方法　以一级亲属 5 5例为观察组 ,4 2例性别、年龄、体重指数 (BMI)与之相匹配的无糖尿病家族史的正常人为对照组 ,比较两组口服 75g葡萄糖耐量试验 (OGTT)中 0、6 0、90、12 0分钟血糖、胰岛素 (INS)、C 肽 (CP)及空腹血脂。结果　 (1)一级亲属组较正常对照组 0点胰岛素和C 肽以及稳态模型法 (HOMA)计算的胰岛素抵抗指数 (HOMA IR)显著性升高。一级亲属组空腹甘油三酯(TG)升高 ,而高密度脂蛋白胆固醇 (HDL C)降低 ,两组有显著性差异。 (2 )一级亲属BMI<2 3,2 3≤BMI <2 5 ,BMI≥ 2 5三个亚组比较 0点血糖无差异 ,而 6 0、90、12 0分钟三点血糖 ,0、6 0、90、12 0分钟胰岛素、C 肽、HOMA IR随BMI的增加而增加 ,且有显著性差异。三个亚组之间血脂比较总胆固醇(TC)和TG亦有显著性差异。 (3)TG与空腹INS、C 肽、HOMA IR呈显著正相关。一级亲属HOMA IR与BMI、TG、空腹INS、C 肽呈显著正相关。结论　 2型糖尿病患者非糖尿病一级亲属在血糖正常时已存在高胰岛素血症 ,胰岛素抵抗 ,同时伴有高TG ,低HDL C血症等脂代谢紊乱。一级亲属中 。Objective To study insulin resistance and dyslipidemia in the nondiabetic first degree relatives with type 2 diabetes.Methods A total of 55 nondiabetic first degree relatives with type 2 diabetes and 42 sex ,age and BMI matched control subjects without a family history of diabetes.All subjects underwent 75g OGTT for 0,60,90,120 minutes glucose,insulin and C peptide and baseline blood lipids determination.Results 1.INS 0,CP 0 and HOMA IR were significantly higher in relatives than those in controls.TG was higher and HDL C was lower in relatives.2.The first degree relatives were classified into three subgroups according to BMI<23,23≤BMI<25,BMI≥25,with BMI increasing,HOMA IR,TG,TC,glucose 60,90,120,and INS,CP 0,60,90,120 were significantly higher.3.TG was significantly correlated with INS 0,CP 0,HOMA IR.A significant correlation could be found between HOMA IR with BMI,TG,INS 0,CP 0.Conclusion Insulin resistance and dyslipidemia could appear early in normoglycemia first degree of type 2 diabetes relative.With BMI increasing,insulin resistance and dyslipidemia are more serious in the first degree relatives.

关 键 词：2型糖尿病 一级亲属 胰岛素抵抗 脂代谢紊乱 发病机理 

分 类 号：R587.1[医药卫生—内分泌]