餐后高甘油三酯血症与胰岛素抵抗关系分析

Insulin Resistance Phenomenon Due to High Triglyceridemia PostprandiaLly

目的:探讨高甘油三酯血症与胰岛素抵抗(IR)的关系。方法:56例青年男性分为试验组和对照组(各28例),试验组行脂肪耐量试验。两组于空腹、餐后3、8h分别采血,测定甘油三酯(TG)、高密度脂蛋白-胆固醇(HDL-C)、血糖(GLU)、胰岛素(INS)水平,并计算3个时间点胰岛素敏感性指数(ISI,=log(1/GLU.INS))。结果:试验组有4/28存在富含甘油三酯脂蛋白(TRL)清除延迟。3/4TRL清除延迟者餐后8h,ISI均值低于试验组餐后3h均值;试验组在餐后3h高TG/低HDL-C应答同时,ISI降低(与空腹及对照组相比P<0.01)。提示产生胰岛素抵抗(IR)现象。结论:餐后高TG/低HDL-C/TRL清除延迟是一组动脉粥样硬化相关脂蛋白表型;可导致胰岛素抵抗。合理膳食、防治高TG血症是解决这些问题的根本措施。提出甘油三酯代谢紊乱综合征的概念,认为甘油三酯代谢紊乱综合征是代谢水平脂质紊乱和多种动脉粥样硬化相关危险因素的病理基础。

Objective： To discuss the relationship between the induced insulin resistance （IR） and arteriosclerosis（AS） due to a butter loading meal. Method： Twenty eight youg men served as test subjects and another 28 as controls. A fattolerance test was taken to the test subjects. In fasting and postprandial （3 and 8h after meal） , plasma triglyceride （TG） ,high density lipoprotein-cholysterol （HDL-C）, glucose （GLU） and insulin （INS） were determined, And an insulin sensitivity index （ISI） was calculated by formula ISI, ：log [1/GLU · INS]. Result： Delayed clearance of triglyceriderich lipoproteins（TRL）was found in 4 out of 28 test subjects. 3 out of 4 cases of delayed clearance of TRI, were lower ISI at postprandial 3h than 8h in the test subjects. ISI in test subjects compared with that of the fasting and controls was significantly different （P〈0.01）. Decreased ISI and IR phenomenon were happened in company with high TG/low HDL-C response 3h postprandial. Conclusion： Postprandial high TG/low HDL-C/delayed clearance of TRL were arteriosclerosisrelated lipoprotein phenotypes and can induce IR , which is a risk factor for AS. Balanced diet and preventing hypertriglyceridemia was the basic measurement for these risk factors. The data recommended that TG abnormalities syndrome should be the pathological bases of dyslipidemia on the metabolic levels and arteriosclerosis-related risk factors.