正常BMI中腹型肥胖患者胰岛素原水平与胰岛素抵抗

Proinsulin and Znsulin resistance in abdominal adiposity adult with normd BMI

目的探讨2型糖尿病和正常糖代谢者中正常BMI腹型肥胖患者胰岛素原水平及其与胰岛素抵抗关系。方法对体重指数(BMI)<24kg/m2的130例2型糖尿病和正常糖代谢组分为腹型肥胖及非腹型肥胖两个亚组,测定空腹血糖、胰岛素、胰岛素原和C肽。结果(1)亚组间:在T2DM组中,腹型肥胖组胰岛素原及HOMA-IR值显著高于非腹型肥胖组。经协方差校正BMI后,HOMA-IR值仍存在显著差异。(2)T2DM组与NGT组间:A组C肽、胰岛素原和HOMA-IR值均显著高于C组;B组C肽和HOMA-IR值均显著高于D组。(3)相关性分析:腰围与胰岛素、胰岛素原和HOMA-IR值均呈正相关。胰岛素原与HOMA-IR值呈正相关。结论(1)即使在正常BMI中,2型糖尿病中腹型肥胖患者表现出更显著的胰岛素抵抗。(2)胰岛素原可能是一个胰岛素抵抗的指标。

Objective To investigate proinsulin and its relation with insulin resistance in abdominal adiposity of type 2 diabetes mellitus and normal glucose tolerance who belonged to normal weight peopleAlethods 130 cases of subjects whose BMI less than 24kg/m^2 contained TEDM and NGT,and the two groups both were devided into two subunits as abdominal adiposity group and non abdominal adiposity group.Fasting blood glucose,insulin,proinsulin and C peptide were measured.Results （1）Between subunits：In T2DM group, The PI and HOMA-IR in abdominal adiposity group were more than the other group,Mter adjustment of BMI,there was still signifi- cantly differece of HOMA-IR.（2）Between T2DM and NGT,The CP,PI and HOMA-IR in A group were more than C group, and CP, HOMA-IR in B group were more than D group.All of these were statistically significant difference. （3）Spearman correlation analyses： Waist circumference was positively related with insulin,proinsulin and HOMA-IR.The association between IRI and HOMA-IR were also positive correlation.Conclusion （1） Even in normal weight adults, abdominal adiposity subjects with type 2 diabetes mellitus displayed more significant insulin resistance （IR）. （2）Proinsulin may be a IR index.