糖调节受损者胰岛素抵抗和β细胞功能的差异

Insulin resistance and β-cell function in patients with impaired glucose regulation

目的:研究3种糖调节受损状态胰岛素抵抗和β细胞功能的差异。方法:根据口服糖耐量试验31例研究对象分为正常糖耐量(NGT)组、孤立空腹血糖受损(I-IFG)组、孤立糖耐量减低(I-IGT)组和联合糖耐量减低(C-IGT)组。正葡萄糖钳夹技术测定胰岛素抵抗程度;静脉葡萄糖刺激胰岛素释放试验测定胰岛素一相分泌量和二相分泌量。结果:I-IFG、I-IGT、C-IGT 3组葡萄糖输注速率(G IR)与NGT组相比均明显减低(P<0.05,P<0.01,P<0.01)。I-IGT、C-IGT组胰岛素一相分泌量明显低于NGT组(P<0.05),二相分泌量明显高于NGT组(P<0.01),I-IFG组与NGT组无差别。结论:I-IGT、C-IGT组既有胰岛素抵抗,又有β细胞分泌功能受损。I-IFG组仅有胰岛素抵抗。

Objective： To study the difference of insulin resistance and β-cell function in patients with 3 categories of impaired glucose regulation. Methods： According to oral glucose tolerance test （OGTT）, 31 patients were divided into normal glucose tolerance （NGT） group, isolated impaired fasting glucose（I-IFG） group, isolated impaired glucose tolerance（I-IGT） group, and combined impaired glucose tolerance（C-IGT） group. We performed the euglycemic clamp and intravenous glucose tolerance test to evaluate the degree of insulin resistance and the insulin secretion of the first and the second phase, respectively. Results： The glucose injection rate, an index of insulin sensitivity, in I-IFG group, I-IGT group, and C-IGT group was all lower than that in NGT group （P 〈 0. 05, P 〈 0. 01, and P 〈 0. 01 ）. In the first phase, the insulin secretion in I-IGT group and C-IGT group was lower than that in NGT group （P 〈 0. 05 and P 〈 0. 01 ）. But in the second phase, the converse was true. There was no differece in the first and the second phase insulin secretion between I-IFG group and NGT group （P 〉 0. 05）. Conclusion： The patients with I-IGT and C-IGT are characterized by insulin resistance and β-cell dysfunction, while those with I-IFG only develop insulin resistance.