空腹血糖受损与糖耐量受损者胰岛β细胞功能及胰岛素抵抗的比较

Study on the pancreatic β cell function and insulin resistance in impaired fasting glucose and impaired glucose tolerance

目的:比较空腹血糖受损与糖耐量受损者胰岛β细胞功能及胰岛素抵抗的不同。方法:选择正常糖耐量者40例,空腹血糖受损者32例,糖耐量受损者38例。测体重指数、血压、血脂、空腹及糖负荷后的血糖、血胰岛素。用稳态模式胰岛素抵抗指数HOM A-IR抵抗作为胰岛素抵抗指标,稳态模式HOM A-β作为基础胰岛素分泌指标,糖负荷30m in净增胰岛素/净增葡萄糖作为早期胰岛素分泌指数。结果:空腹血糖受损组HOM A-IR较耐量受损组增高,差异有显著性(P<0.05)。空腹血糖受损组HOM A-β较糖耐量受损组降低,差异有显著性(P<0.05)。糖耐量受损组净增胰岛素/净增葡萄糖与空腹血糖受损组比较有下降,但差异无统计学意义。结论:空腹血糖受损人群较糖耐量受损人群有着更严重的胰岛素抵抗,空腹血糖受损人群基础状态下胰岛β细胞功能受损,而糖耐量受损人群的早期胰岛素分泌反应减弱。

Objective To compare the difference of pancreatic β-cell function and insulin resistance between impaired fasting glucose and impaired glucose tolerance. Methods Forty patients with normal glucose tolerance, 32 with impaired fasting glucose and 38 with impaired glucose tolerance were measured their levels of body mass index, blood pressure, plasma glucose, lipids and insulin. Homeostasis model assessment （HOMA） was applied to assess the status of insulin resistance （HOMA- IR） and basic function of pancreatic β-cell （HOMA-β cell）. While insulinogenic index, the ratio of the increment of insulin to that of plasma glucose 30 minutes after a glucose load, △I30/△G30 were used to evaluate the insulin secretion in the early stage. Results In the group of impaired fasting glucose, HOMA-IR was greatly increased, and HOMA-β was decreased, with a significant difference compared with those in the group of impaired glucose tolerance （P〈0.05）. There was no significant difference in △I30/△G30 between two groups. Conclusion Insulin resistance is more severe in impaired fasting glucose group than in impaired glucose tolerance group. The impaired fasting glucose subjects have basic insulin secretion deficiency. The impaired glucose tolerance subjects have insulin secretion weakening in the early stage.