摘要
目的 探讨空腹血糖异常人群的胰岛素分泌及胰岛素抵抗状态。 方法 选择包钢糖尿病普查中复查口服葡萄糖耐量试验 (OGTT) 3985例 ,分为 6组 :正常糖耐量 (NGT)组 2 5 88例 ,异常空腹血糖 (IFG)组 2 72例 ,糖耐量减低 (IGT)组 4 4 9例 ,空腹血糖异常伴糖耐量减低 (IFG/ IGT)组116例 ,新诊断糖尿病 (DM1)组 338例 ,已知糖尿病 (DM2 )组 2 2 2例。测腰围、体重指数、血压、血脂及血浆胰岛素 ,应用稳态模式胰岛素抵抗指数 (HOMA- IR)作为胰岛素抵抗指标 ,稳态模式胰岛 β细胞功能指数 (HBCI)及胰岛素分泌指数 (IS)作为胰岛素分泌指标 ,并对 6组患者的这些指标及临床特征 ,进行对比分析。 结果 与 NGT组比较 ,IFG组 HOMA- IR(1.4 6± 0 .6 0 ,1.0 6± 0 .6 4 ,t=- 6 .716 ,P<0 .0 0 1)、空腹胰岛素 (FINS) (17.90± 10 .0 6 ,15 .79± 10 .94 ,t=- 2 .0 71,P=0 .0 39)增高 ,HB-CI(4.6 5± 0 .6 0 ,5 .2 7± 0 .76 ,t=3.399,P<0 .0 0 1)及 IS(0 .86± 0 .6 0 ,0 .99± 0 .6 2 ,t=2 .36 6 ,p=0 .0 18)降低 ;IGT组 HOMA- IR(1.39± 0 .5 8,t=4 .6 98) ,FINS(2 1.2 7± 15 .39,t=4 .4 93)、2 - h胰岛素(6 0 .84± 37.86 ,t=8.4 82 )、HBCI(5 .4 7± 0 .79,t=2 .6 98)、IS(1.2 5± 0 .6 1,t=4 .0 34,P值均
Objective The purpose of this study was to explore characteristics of beta cell function and insulin resistance in subjects with impaired fasting glucose (IFG). Methods A total 3 985 subjects (2 664 males, 1 321 females), aged 20～89 years, were studied. 75 g oral glucose tolerance test was performed after a 10 h overnight fasting, and fasting insulin (FINS), 2 h insulin (2 hINS) levels were measured. These subjects were divided into six groups: normal glucose tolerance (NGT)( n =2 588), impaired fasting glucose (IFG) ( n =272), impaired glucose tolerance (IGT) ( n =449), IFG/IGT ( n =116), newly diagnosed diabetes mellitus (DM1) ( n =338), known diabetes mellitus (DM2) ( n =222). We evaluated their insulin secretion and insulin resistance by IS=FINS/FPG, HBCI=20×FINS/(FPG 3.5), and Homa IR=(FPG×FINS)/22.5, and WC,BMI,SBP,DBP,TC,TG and HDL C. Results Homa IR was higher in subjects with IFG, IGT and IFG/IGT than that in subjects with NGT (1.46±0.60, 1.39±0.58, and 1.70±0.61 vs 1.06±0.64, P = 0.001 ), but there was no significance between IFG and IGT( t=-1.303,P =0.193). Subjects with IFG had higher FINS level than NGT (17.90±10.06 vs 15.79±10.94, P =0.039). There was no significance between IFG and NGT ( P =0.072) for 2 hINS. HBCI and IS were lower in subjects with IFG than subjects with NGT and IGT(HBCI 4.65±0.60 vs 5.27±0.76 and 5.47±0.79, P <0.01), (IS 0.86±0.6 vs 0.99±0.62 and 1.25±0.61, P=0.04, P <0.001, respectively). Conclusion The subjects with IFG might have hepatic insulin resistance and defect of insulin secretion. The IGT might have peripheral insulin resistance and high insulin secretion. Both IFG and IGT presented as clinical features of the metabolic syndrome. IFG/IGT showed significant defect in insulin secretion. Compared with IFG and IGT, the defect in insulin secretion of IFG/IGT approached diabetes mellitus.
出处
《中国糖尿病杂志》
CAS
CSCD
2002年第6期333-336,共4页
Chinese Journal of Diabetes
