糖耐量受损者胰岛素抵抗和β细胞功能的研究

Study on insulin resistance and β cell function in patients with impaired glucose tolerance

目的 探讨糖耐量受损 (IGT)患者胰岛素抵抗、β细胞功能和相关的代谢改变。 方法 对 6 4例血糖正常者 (NGT)和 97例IGT患者进行口服葡萄糖耐量试验 (OGTT)、胰岛素释放试验 ,并测定其血脂、血压、体重指数 (BMI)和腰臀比值 (WHR)。结果 与NGT组比较 ,IGT组空腹胰岛素水平、OGTT后胰岛素曲线下面积显著升高 (P <0 0 5 ) ;胰岛素敏感指数、初期胰岛素分泌指数明显降低 (P <0 0 1) ;胰岛素敏感指数依次与腰臀比值、BMI、甘油三脂 (TG)、高密度脂蛋白 胆固醇 (HDL C)、空腹血糖和舒张压相关 ;IGT患者TG、舒张压、收缩压、BMI和腰臀比值明显增高 ,HDL C明显降低。结论 IGT患者存在胰岛素抵抗和 β细胞功能异常并伴有多种代谢紊乱。

Objective To investigate the insulin resistance,islet β cell function and associated metabolic changes in patients with impaired glucose tolerance(IGT).Methods Oral glucose tolerance test(OGTT),insulin release test were carried out,meanwhile serum lipid,blood pressure,body weight index(BMI) and waist/hip ratio(WHR) measured in 64 control subjects with normal glucose tolerance(NGT group) and 97 patients with IGT.Results Compared to the NGT group,fasting insulin level and insulin area under the curve after OGTT increased markedly(P<0.05),insulin sensitivity index and early insulin secreation index decreased significantly(P<0.01) in patients with IGT;Insulin sensitivity was related to WHR,BMI,triglyceride,high-density lipoprotein-cholesterol,fasting blood glucose,diastolic pressure and systolic pressure successively in 97 patients;WHR,BMI,triglyceride,diastolic pressure and systolic pressure in IGT patients were higher than those in NGT group,however HDL-C in IGT patients was lower than that in NGT group(P<0.05).Conclusion There exist obvious insulin resistance,defect islet β cell and various of metabolic turbulences in patients with IGT.