不同糖代谢状态下游离脂肪酸与胰岛素抵抗和胰岛β细胞功能的相关性研究

Association between insulin resistance/beta cell function and free fatty acid on varying glucose-tolerant subjects

目的 游离脂肪酸 (FFAs)水平在不同糖代谢状态下对胰岛素抵抗和胰岛 β细胞分泌功能的影响。 方法 选自2 0 0 1- 0 5 2 0 0 3- 11在中国医科大学附属第一医院住院的糖耐量正常 (NGT) 2 8例 ,空腹血糖异常 (IFG)患者 2 0例 ,糖耐量低减 (IGT)患者 2 3例 ,IFG/IGT患者 2 6例 ,2型糖尿病 (T2DM)患者 2 5例。测定各组FFAs水平 ,稳态模型评估胰岛素敏感性 ,HOMA IS及OGTT中糖负荷后 30分钟胰岛素增值与血糖增值的比值评估胰岛 (细胞分泌功能。结果 (1)IGT组、IFG/IGT组及T2DM组患者FFAs水平明显高于NGT组 ;IFG/IGT组患者FFAs水平明显高于IFG组 ;T2DM组患者FFAs水平低于IGT组。 (2 )IGT组、IFG/IGT组及T2DM组患者HOMA IR均明显高于NGT组。(3)胰岛素分泌功能均以T2DM患者变化最显著。 (4)FFAs与HOMA -IR呈正相关 ;FFAs与胰岛素分泌指数呈负相关 ,FFAs与HOMA β细胞功能指数呈负相关。

Objective To understand the effects of serum free fatty acid (FFAs) on insulin resistance and beta cell function on varying glucose-tolerant subjects.Methods There were 28 subjects with normal glucose tolerance (NGT),20 cases of impaired fasting glucose(IFG),23 cases of impaired glucose tolerance (IGT),and 26 cases of IFG/IGT and 25 cases of type 2 diabetes (T2DM).The FFAs were detected,insulin resistance was evaluated by HOMA-IR,and beta cell function was evaluated by HOMA-IS and △I30/△G30.Results (1)Serum FFAs was significantly higher in patients of IGT,IFG/IGT and T2DM than those in NGT (P<0.001).The level of FFAs was higher in IFG/IGT group than in IFG group,while it was lower in T2DW group than in IGT group.(P<0.05 ).(2)HOMA-IR in IGT,IFG/IGT and T2DM was significantly higher than in NGT(P<0.001),but there wasn’t obvious difference among these three groups.(3)The result of HBCI was T2DM<IFG/IGT<IGT<NGT.The result of △I30/△G30 was also T2DM<IFG/IGT<IGT<NGT.(4)FFAs was positively correlated with HOMA-IR(P<0.01).FFAs was negatively correlated with HOMA-IS (P<0.01).FFAs was also negatively correlated with △I30/△G30 after 75g OGTT (P<0.01).Conclusion FFAs level is closely related to insulin resistance and insulin secretion defects.