肥胖与胰岛素抵抗的关系

Relationship Between Obesity and Insulin Resistance

目的:探讨肥胖类型与胰岛素抵抗(insulinresistance,IR)及β细胞功能的关系。方法:采用稳态模式胰岛素抵抗指数(HOMA-IR)评价胰岛素抵抗,根据亚-太地区成人体重分级建议将研究对象分为非肥胖组、周围型肥胖组、腹型肥胖组,观察三组间血糖、血浆胰岛素水平及HOMA-IR、HOMA-β的差异。结果:(1)本组肥胖的检出率为35.1%(283/807),周围型肥胖、腹型肥胖分别占25.8%及74.2%。(2)非肥胖组、周围型肥胖组、腹型肥胖组IR的检出率分别为12.0%、26.0%、50.0%。(3)与非肥胖组相比,周围型肥胖组及腹型肥胖组的FPG、PG2h、HOMA-IR均明显增高,腹型肥胖组较其他两组具有更高的FIns、PG2h、HOMA-IR,而HOMA-β明显降低。结论:肥胖与IR关系密切,腹型肥胖者具有更严重的IR以及更严重的β细胞功能下降。

Subjective： To investigate the relationship between obesity and insulin resistance （IR）. Methods： Homeostasis model assessment （HOMA） was applied to assess the status of IR. 807 subjects were divided into non- obesity,subcutaneous obesity and abdominal obesity group according to the suggestion of grading body weight in Asia. The differences in blood glucose, plasma insulin level, HOMA-IR and HOMA-β among the three groups were observed. Results： （1）The incidence of obesity was 35.1%（283/807）, subcutaneous obesity （25.8%） and abdominal obesity （74.2%）. （2）The incidence of IR was 12.0% in non-obesity, 26.0% in subcutaneous obesity and 50.0% in abdominal obesity group. （3）Compared with the non- obesity, subcutaneous obesity and abdominal obesity group had higher FPG, PG2h, HOMA-IR （P 〈 0.05）. The abdominal obesity group had higher FIns,PG2h,HOMA-IR and lower HOMA-βthan that in other two groups. Conclusion： Obesity was significantly associated with IR. The abdominal obesity presented with more serious IR as well as the more serious β cells dysfunction.