2型糖尿病患者正常糖耐量一级亲属红细胞膜胰岛素受体变化及与胰岛素抵抗的相关性

Study of the Relationship of Insulin Receptor with Insulin Resistance in Nondiabetic First-degree Relatives of Type 2 Diabetes Mellitus

目的探讨2型糖尿病患者正常糖耐量一级亲属(NFDR)红细胞膜胰岛素受体变化及与胰岛素抵抗的相关性。方法102例2型糖尿病患者正常糖耐量一级亲属作观察组,60例无糖尿病家族史的非糖尿病患者作对照组,测定空腹血糖(FPG)、胰岛素(FINS)、血脂、餐后2 h血糖(2 h PG)、2 h胰岛素(2 h INS),并检测高、低亲和力红细胞膜胰岛素受体数目(R1、R2)和高、低亲和力常数(K1、K2),同时计算胰岛素抵抗指数(IRI)。结果2型糖尿病患者正常糖耐量一级亲属R1、R2明显低于对照组;2 h PG、三酰甘油、低密度脂胆白胆固醇水平高于对照组,差别有统计学意义(P<0.05,P<0.01);FINSI、RI高于对照组,差别有统计学意义(P<0.05)。多元线性逐步回归分析结果显示,体质指数、三酰甘油、R1、R2是影响2型糖尿病患者正常糖耐量一级亲属胰岛素抵抗独立的危险因素。结论2型糖尿病患者正常糖耐量一级亲属存在明显胰岛素抵抗,且与红细胞膜胰岛素受体数目的减少有一定关系。

Objective To investigate the relationship of insulin receptor with insulin resistance （IR） in the nondiabetic first- degree relatives of type 2 diabetes mellitus （T2DM）. Methods The levels of fasting blood （FBG）, fasting serum insulin （FINS）, as well as lipid, PBG, 2 h INS, erythrocyte insulin receptor （R） were detected in 102 nondiabetic first-degree relatives of T2DM and 60 control subjects （C）. Results 1） the numbers of R1 and R2 were significantly lower and levels of TG ＆ LDL-C were significantly higher in nondiabetic first-degree relatives of T2DM than those in control subjects （P〈0.05）. 2）IRI was significantly higher in the nondiabetic first-degree relatives of T2DM than those in control subjects （P〈0.05）. 3） In the nondiabetic first-degree relatives of T2DM, a multiple linear stepwise regression analysis indicated that BMI, TG, R1 and R2 were independent factors that affected IRI. Conclusion There were the higher insulin resistance in the nondiabetic first-degree relatives of T2DM than those in control subjects, R1 and R2 might play an important role in pathogenesis of insulin resistance.