单纯性肥胖患者肠促胰岛素分泌激素分泌特点的研究

The changes of secretion mode of incretin in simple obesity

目的比较单纯性肥胖者和正常体重者肠促胰岛素分泌激素的分泌特点。方法选取正常葡萄糖耐量、BMI<24 kg/m2的志愿者10例作为正常对照组,以正常葡萄糖耐量、BMI≥25 kg/m2者7例为肥胖组,均进行75 g葡萄糖负荷,并检测两组受试者的0、15、30、60、90、120 min的血糖、血清胰岛素和血浆胰岛素样多肽1(GLP-1)、葡萄糖依赖促胰岛素分泌肽(GIP),并计算曲线下面积(AUCGLP-1、AUCGIP)。结果肥胖组的血糖峰值升高并后移,胰岛素分泌增加伴高峰后移。肥胖组整体GLP-1分泌水平低于正常组[AUCGLP-1差异有统计学意义(P<0.05)]。肥胖组GIP分泌模式与正常组相似,但血浆水平较正常组升高[AUCGIP差异有统计学意义(P<0.05)]。结论在胰岛素分泌增加、胰岛素抵抗存在的同时,单纯性肥胖者的GLP-1分泌减少,GIP分泌增加。提示两者在单纯性肥胖的病理生理机制中可能发挥着不同的作用。

Objective To compare the secretion of incretin hormones between simple obesity and normal weight healthy people.Methods Selected 10 volunteers with normal glucose tolerance and BMI <24 kg/m2 as control group,7 patients with normal glucose tolerance and BMI≥25 kg/m2 as obesity group.All subjects were detected blood glucose,serum insulin and plasma GLP-1,GIP at 0,15,30,60,90,120 min during oral 75 g glucose tolerance test.Results In obese group,the peak of blood glucose and insulin were elevated and delayed than control group.The plasma GLP-1 level of obese group was significantly lower than normal group(AUCGLP-1 176.0±56.0 vs.335.8±47.0,P=0.038).The GIP secretion pattern was similar between two group,but the GIP plasma levels was higher than that of normal group(AUCGIP 1844.3±260.0 vs.1171.6±152.5,P=0.017).Conclusions The plasma level of GLP-1 is decreased,and accompany with increase secretion of GIP and insulin simultaneously in these simple obesity,they may be to play difference role in the mechanism of obesity.