摘要
目的 研究肥胖患者胰岛素原水平的变化及其与胰岛素抵抗的关系。方法 采用放射免疫法测定1 52例肥胖者 (OB组 )和 47例正常对照组 (C组 )的特异性胰岛素和胰岛素原。OB组包括糖耐量正常者 68例(NGT组 ) ,糖耐量异常 /空腹血糖受损者 46例 (IGT组 )和糖尿病 38例 (DM组 )以及单纯性肥胖者 32例 (SOB组 )。采用稳态模式 (HOMA)评价胰岛素抵抗程度。结果 (1 )OB组和SOB组的HOMA值高于C组 (P <0 .0 0 1 ) ,从C组NGT组IGT组和DM组 ,HOMA值逐渐增高 ;(2 )OB组、SOB组和NGT组的胰岛素原水平均高于C组 (P <0 .0 0 1 ) ,在体重指数 (BMI)相同情况下 ,IGT组和DM组的胰岛素原水平高于NGT组 (P <0 .0 1 ) ;(3)胰岛素原水平与胰岛素抵抗显著相关 (r=0 .62 ,P <0 .0 0 1 ) ,该相关性独立于年龄、BMI、脂代谢和血压。结论 空腹血清胰岛素原水平在肥胖患者中异常升高 ,在伴有糖耐量异常或糖尿病的肥胖患者中 ,胰岛素原水平进一步升高。
Purpose: To investigate the changes of proinsulin and its relationship to insulin resistance in obese subjects. Methods: Specific insulin and proinsulin were measured by radioimmunoassay in fasting serum of obese subjects (group OB, n = 152) and controls (group C, n = 47). Group OB included subjects of normal glucose tolerance (group NGT, n = 68), impaired glucose tolerance/impaired fasting glucose group IGT, n = 46), diabetes (group DM, n = 38) and simple obese (group SOB, n = 32). Insulin resistance was estimated by homeostasis model assessment (HOMA). Results: (1) HOMA value was higher in group OB and SOB than group C(P<0.001). The value was increased stepwised from group C&rarrNGT&rarrIGT and DM. (2) group OB, SOB and NGT had a higher proinsulin levels than group C (P<0.001). Proinsulin levels of group IGT and DM were higher than that of group NGT (P < 0.01). (3) Proinsulin level was significantly associated with HOMA value (r = 0.62, P< 0.001), which was independent of age, BMI, lipometablism and blood pressure. Conclusions: Fasting serum proinsulin level increased in obese subjects. It further increased in obese with impaired glucose tolerance and diabetes. Proinsulin was an independent affective factor of insulin resistance.
出处
《复旦学报（医学版）》
EI
CAS
CSCD
北大核心
2002年第3期200-203,共4页
Fudan University Journal of Medical Sciences
