2型糖尿病血清中游离脂肪酸与血糖及胰岛素抵抗关系的比较

Comparison of Relationship between Free Fatty Acid,Plasma Glucose and Insulin Resistance in Patients with Type 2 Diabetes Mellitus

目的:探讨2型糖尿病(2DM)患者血清中游离脂肪酸(FFA)浓度与胰岛素抵抗(IR)的关系。方法:采用放射免疫法(RIA)测定胰岛素浓度,已糖激酶法测定GLU,酶产色法测定空腹FFA浓度、2 hFFA浓度(PFFA)及其他生化指标。86例2 DM患者,50例健康对照组行口服葡萄糖耐量试验(OGTT)和胰岛素释放试验,计算30 min后胰岛素和GLU浓度变化的比值(△I30/△G30)、葡萄糖曲线下面积(AUCG)和胰岛素曲线下面积(AUCIN)。根据Cederholm公式计算胰岛素敏感指数(ISI)。结果:①与正常对照比较,2DM空腹和2 h FFA、AUCG、AUCIN、TG浓度显著升高(P<0.01);ISI、△I30/△G30显著降低(P<0.01)。②2DM患者FFA与AUCG、AUCIN呈显著正相关,与△I30/△G30、ISI呈显著负相关。结论:2DM患者空腹血清FFA、胰岛素浓度升高;高浓度FFA使葡萄糖刺激胰岛素分泌(GSIS)受损,血糖浓度升高;并且间接反映IR的程度。

Objective:To evaluate the relationship between free fatty acid(FFA), plasma glucose and insulin resistance(IR)in type 2 diabetes mellitus(2DM).Methods:The concentration of insulin, glucose, fasting and postponed 2 hours FFA(PFFA)and other biochemical indexes had been measured with radioimmunoassay method,hexoknase method and chromogenic method.Oral glucose tolerance test and insulin release test were performed in 86 cases with 2DM and 50 cases healthy people for calculating glucose and insulin area under the curve (AUCG,AUCIN),the ratio of insulin change to glucose change during the first 30 min after glucose ingestion (△I 30/△G 30)and insulin sensitivity index(ISI) according to cederholm formula.Results:①Compared with normal people,fasting FFA,TG,PFFA,AUCG and AUCIN were obviously higher(P<0.01)and ISI,△I 30/△G 30 were lower in 2DM(P<0.01).②There were significantly positive correlation between FFA and AUCG,AUCIN,and negative correlation between FFA and ISI,△I 30/△G 30.Conclusion:Fasting blood FFA and insulin increase in type 2DM, the high concentration of FFA can harm the secretion of insulin from stimulation of glucose, increase the concentration of blood glucose, which reflect IR indirectly.