2型糖尿病患者糖耐量正常一级亲属胰岛β细胞功能及胰岛素抵抗的临床观察

Investigation of the Insulin Resistance and Islet β-cell Function in Normal Glucose Tolerance First-degree Relatives of Type 2 Diabetes Mellitus

目的:对2型糖尿病患者糖耐量正常一级亲属进行临床观察,了解其胰岛β细胞功能及胰岛素抵抗情况。方法:选择确诊2型糖尿病患者糖耐量正常的一级亲属168例,分为无高血压和脂代谢紊乱组(A组)、高血压组(B组)、脂代谢紊乱组(C组)、高血压和脂代谢紊乱组(D组)4组,并进一步将其分为BMI<25和BMI≥25两亚组,比较各组FIns、IRI、△I30/△G30等变化。结果:D组与A组、B组、C组比较,腰围(WC)、腰臀比(WHR)、体质指数(BMI)、空腹血糖(FBG)I、RI和FIns显著升高(P<0.01),△I30/△G30显著降低(P<0.01);上述代谢指标在C组和B组间比较无统计学意义;B组和C组与A组比较,WC、WHR、BMI、FBGI、RI和FIns有明显升高(P<0.05),△I30/△G30有明显降低(P<0.05),△I30/△G30均明显降低(P<0.05)。结论:2型糖尿病患者糖耐量正常的一级亲属,高血压和(或)脂代谢紊乱的存在使IR进一步加重,早期胰岛β细胞分泌功能进一步降低,这种作用对于肥胖者更趋明显。

Objective: To investigate the insulin resistance and islet β-cell function in normal glucose tolerance first-degree relatives of type 2 diabetes mellitus(T2DM).Methods: 168 normal glucose tolerance subjects were divided into four groups:no hypertension and dyslipidemia (Group A),plus hypertension (Group B),plus dyslipidemia (Group C),plus hypertension and dyslipidemia (Group D).Furthermore they were divided into (BMI<)25 subgroup and (BMI≥)25 subgroup,the levels of Fins,IRI,△I_(30)/△G_(30),etc.were measured in all groups.Results: Compared with Group A,B,C, Group D had significantly higher values of WC,WHR,IRI,FIns((P<)0.01),significantly lower values of △I_(30)/△G_(30)((P<)0.01).Compared with (BMI<)25 subgroup,(BMI≥25) subgroup had singnificantly higher values of FIns,IRI((P<)0.05),the singnificantly lower values of △I_(30)/△G_(30)((P<)0.05).The metabolic indexes were in no difference between Group B and Group A.Conclusion: To the normal glucose tolerance first-degree relatives of T2DM,along with adding hypertension and dyslipidemia in four groups,the insulin resistance increased and early secretion of islet β-cell decreased gradually.The effect was more obvious in obese subjects.