糖耐量低减患者红细胞胰岛素酶活性与胰岛素抵抗(英文)

Relationship between erythrocyte insulinase activity and insulin resistance in patients with impaired glucose tolerance

背景:糖耐量低减发病主要与遗传和环境因素有关,环境因素包括摄入热量过多和肥胖等。胰岛素抵抗是其主要发病机制之一。目的:探讨糖耐量低减患者的红细胞胰岛素酶活性(erythrocytesinsuli-naseactivity,EIA)与胰岛素抵抗的关系,为运动改善糖耐量低减患者的胰岛素抵抗提供理论支持。设计:以IGT患者为研究对象,以正常糖耐量的成年人为对照组的观察对比研究。单位:一所军医大学医院的内分泌科。对象:本研究于2001-01/2003-04在第一军医大学南方医院内分泌科完成。随机抽取住院和门诊的糖耐量低减患者50例,男26例,女24例,年龄(52±7)岁。纳入标准:符合WHO1999年口服葡萄糖耐量实验(OGTT)的糖耐量低减诊断标准,心、肝、肾功能和血常规均在正常范围,且未使用任何抗糖尿病药物者。排除标准:患肝脏、肾脏疾患、感染、恶性肿瘤、冠心病、脑血管意外和结缔组织疾病者。根据是否合并空腹血糖异常将糖耐量低减患者分为合并空腹血糖异常的糖耐量低减1组,共20例,男9例,女11例;单纯餐后高血糖未合并空腹血糖异常的糖耐量低减2组,共30例,男17例,女13例。20例正常糖耐量的成年人作为对照组,男女各10例,年龄(48±12)岁。方法:用放射酶分析法检测所有研究对象的EIA,同时检测患者的血糖、血清胰岛素和糖基化血红蛋白,并计算?

BACKGROUND:Impaired glucose tolerance(IGT) is mainly related to genetic factors and environmental factors including excessive calorie intake and obesity.Insulin resistance(IR) plays a major role in the onset of IGT. OBJECTIVE:To investigate the relationship between erythrocyte insulinase activity(EIA) and IR in patients with IGT so as to provide theoretic basis for improving IR in patients with IGT by exercise. DESIGN: Observational and comparative study based on IGT patients as the subjects and adults with normal glucose tolerance as controls. SETTING:Department of endocrinology of a hospital affiliated to a military medical university. SUBJECTS: The study was conducted in the Department of Endocrinology of Nanfang Hospital, First Military Medical University of Chinese PLA,from January 2001 to April 2003.A total of 50 inpatients and outpatients with IGT,26 males and 24 females aged(52±7)years,were randomly selected.Inclusion criteria:those whose diagnosis met the WHO 1999 for criteria oral glucose tolerance test (OGTT) and whose heart,liver and kidney functions and blood test were within the normal range without taking any antidiabetics.Exclusion criteria:those who had liver and kidney diseases,infection, malignant tumor, coronary heart disease,cerebrovascular disorder and connective tissue disease.The patients with IGT were divided into 2 subgroups according to the presence of abnormal fasting plasma glucose (FPG). Subgroup A consisted of 20 patients (9 males and 11 females) with IGT accompanied with impaired FPG. Subgroup B was composed of 30 IGT patients(17 males and 13 females) with normal FPG.Twenty adults with normal glucose tolerance were set as control group(20 females and 10 males) with the age of(48±12)years. METHODS:EIA was measured with the method of radioenzymatic assay in all subjects.Blood sugar,serum insulin and glycosylated hemoglobin were also measured,and homeostasis model analysis-insulin resistance(HOMA-IR) index was calculated for estimation of insulin sensitivity. MAIN OUTCOME MEASURES:The differences and correlation between EIA and HOMA-IR in IGT patients of each group. RESULTS:EIA, serum fasting insulin and HOMA-IR indexes of the patients with IGT were significantly higher than those of the controls (P< 0.01 or P< 0.05). EIA and HOMA-IR of the patients in subgroup A was significantly higher than those in subgroup B(P< 0.01).Linear regression analysis showed that EIA had significant positive correlation with serum fasting insulin,glycosylated hemoglobin and HOMA-IR indexes(r=0.51, 0.44, 0.49, P< 0.01). CONCLUSION:The degradation rate of erythrocyte insulinase in patients with IGT tolerance is significantly higher than that of normal persons,and is closely related to the onset and development of insulin resistance.