不同诊断标准下空腹血糖受损患者脂肪负荷餐后血糖与胰岛素水平的关系  

Relationship between fat loading postprandial blood glucose and insulin level in patients with impaired fasting glucose under two diagnostic criteria

作　　者：鲍婷[1] 王佑娟[1] 唐怀蓉[1] 黄燕[1] BAO Ting;WANG Youjuan;TANG Huairong;HUANG Yan(Health Management Center,West China Hospital,Sichuan University,Chengdu 610041,China)

机构地区：[1]四川大学华西医院健康管理中心,成都四川610041

出　　处：《西部医学》2018年第10期1443-1446,共4页Medical Journal of West China

基　　金：国家重点研发计划专项(2017YFC09077504);四川省科技厅支撑计划项目(2010SZ0170;2011SZ0198)

摘　　要：目的探讨不同诊断标准下空腹血糖受损(IFG)患者脂肪负荷餐后不同时间点血糖和胰岛素的相关性。方法分别于进食脂肪负荷餐后2、4、6、8h采集受试者的血液样本,检测受试者的血糖和胰岛素值,采用直线相关和混合效应模型分析WHO诊断标准与ADA诊断标准下IFG患者不同时间点血糖和胰岛素的关系。结果两种标准诊断的IFG患者年龄、性别构成比、BMI值、WHR值、收缩压和舒张压差异无统计学意义(P>0.05),WHO标准诊断的IFG患者的心率高于ADA标准诊断出的IFG患者,差异有统计学意义(P<0.05);受试者不同测量时间点的GLU、INS指标测量结果差异均有统计学意义(P<0.05);两种诊断标准诊断出的IFG人群,其空腹血糖水平与胰岛素水平存在负相关关系(WHO,r=-0.7227;ADA,r=-0.6780);其餐后4h血糖水平与胰岛素水平存在正相关关系(WHO,r=0.4985;ADA,r=0.3989),且差异均有统计学意义(P<0.05)。结论空腹血糖诊断切点下调可用作提前识别糖尿病前期患者的窗口,有助于糖尿病高危人群的干预及逆转糖尿病进展。Objective To analyze the patients with impaired fasting glucose under different criteria for the diagnosis of different time points after a meal,the changes of blood glucose and insulin levels and provide a basis for screening and early prognosis of pre-diabetes populations.Methods The participants＇ blood samples after a meal 2 h,4 h,6 h,8 h,participants＇ blood glucose and insulin values were observed.The relationship between blood glucose and insulin of IFG patients diagnosed by different standards was analyzed.Results The difference between IFG patients＇ age,gender,BMI,WHR,systolic blood pressure and diastolic blood pressure diagnosed by two standards had no statistical significance（P〉0.05）.The heart rate was statistically significant.The WHO standard diagnosed patient＇s heart rate was higher than the ADA＇s.The difference among different measuring time points of GLU,INS results had statistical significance（GLU：WHO,F=5.01,P=0.0005;ADA,F=3.74,P=0.0049;INS：WHO,F=688.331,P〈0.0001;ADA,F=696.21,P〈0.0001;）.There was a negative correlation relationship between fasting blood＇s glucose and insulin（WHO,r= 0.7227;ADA,r=0.6780）,and a positive correlation relationship between postprandial 4 hblood＇s glucose and insulin level（WHO,r=0.4985;ADA,r=0.3989）.The difference was statistically significant,in two kinds of diagnostic criteria＇s IFG patients.Conclusion The cut of tangent point of fasting plasma glucose will early recognize the people with pre-diabetes and help to take timely intervention measures and prevent progression to diabetes.

关 键 词：空腹血糖受损 血糖 胰岛素水平 脂肪负荷餐 

分 类 号：R587.1[医药卫生—内分泌]