2型糖尿病患者正常糖代谢一级亲属胰岛素抵抗及B细胞功能研究

A study on insulin resistance and β-cell function in normal glucose tolerance first-degree relatives of type 2 diabetics

目的探讨2型糖尿病患者正常糖耐量一级亲属胰岛素敏感性及B细胞功能。方法以糖耐量正常(NGT)一级亲属为观察组,无DM家族史的正常人为对照组,比较两组口服75 g葡萄糖耐量试验(OGTT)中0,120 min血糖,胰岛素,自身稳定型评价-B(HOMA-B)和HOMA-IR。结果正常OGTT情况下,DM一级亲属组血浆空腹血糖、胰岛素和OGTT 120 min血糖、胰岛素,显著高于对照组(P<0.05)。观察组HOMA-B和HOMA-IR显著高于对照组(P<0.01)。结论T2DM患者NGT一级亲属在正常糖耐量情况下,已存在高胰岛素血症和胰岛素抵抗,同时B细胞功能明显改变,胰岛素功能降低和胰岛素抵抗是发生DM的主要机制。

Objective To study insulin resistance and β-cell function in normal glucose tolerance （NGT） first degree relatives of type 2 diabetics. Methods A total of 36 NGT first-degree relatives of type 2 diabetics, and 36 normal persons without diabetes family history joined in the trial. All subjeets underwent a 75 g-OGTT （oral glucose tolerance test） for determinations of 0,120 minlutes＇ glucose and insulin. The HOMA model was used to caculate homeostatic model assessmont-insulin resistance （HOMA-IR） as an index of insulin resistance and HOMA-β as an index of β-cell function. Results The fasting glucose, insulin and OGTT 2 h glucose, insulin levels in observation group were higher than those in control group （P〈0.05）, HOMA-IR and HOMA-β in observation group was higher than that in control group （P〈0.01）. Conclusion Under normal glucose tolerance status, non-diabetic first-degree relatives of type 2 diabeties already show hyperinsulinemia and insulin resistance, and their β-cell function changes significantly. Diabetes occurs when insulin resistance worsens and insulin secretion declines.