腹型肥胖对胰岛素敏感性的影响及其社区干预

Effect of abdominal obesity on insulin sensitivity and its community-based intervation

目的观察腹型肥胖对胰岛素敏感性的影响,并探讨腹型肥胖的社区干预有效方法。方法84例腹型肥胖者与30例健康人的腰围、空腹血糖、空腹血胰岛素、胰岛素敏感指数、胰岛素抵抗指数作统计比较后,将腹型肥胖者分为两组,各42例,进行为期半年的社区干预,一组采用单纯的科学生活方式干预,另一组在此基础上加服二甲双胍0.25 g3次/d,半年后两组的各项指标再作比较。结果腹型肥胖组的腰围、空腹血糖、空腹血胰岛素、胰岛素抵抗指数显著高于健康对照组(P<0.001),而胰岛素敏感指数显著低于健康对照组(P<0.001)。半年干预后,二甲双胍组的腰围、空腹血糖、空腹血胰岛素,胰岛素抵抗指数较本组干预前显著减小(P<0.05),胰岛素敏感指数显著增大(P<0.05),而单纯科学生活方式干预组各项指标前后差异无统计学意义(P>0.05)。结论腹型肥胖导致胰岛素敏感性降低,二甲双胍加科学生活方式综合社区干预对改善腹型肥胖的胰岛素敏感性行之有效。

Objective To examine the effect of abdominal obesity on insulin sensitivity and to evaluate the effectiveness of communitybased intervention for reducing abdominal obesity and improving insulin sensitivity. Methods Waist circumference, fasting blood glucose, fasting serum insulin, insulin sensitivity index, insulin resistance index were obtained in 84 subjects with abdominal obesity and 30 healthy control subjects for statistical comparison. The abdominal obesity subjects were divided into 2 groups （42 in each group）for 6 months intervention, subjects in both groups received lifestyle modificatin, and subjects in group 2 were also given metformin 250 mg, tid. Results Waist circumference, fasting blood glucose, fasting serum insulin ,insulin re- sistance index in the abdominal obesity group were significantly greater, insulin sensitivity index was significantly less, than that of the healthy control group （ P 〈 0. 001 ）. After 6 months of intervention, waist circumference, fasting blood glucose, fasting serum insulin, insulin resistance index in metformin group had significantly decreased and insulin sensitivity index increased （P 〈 0. 05）. By contraries, subjects in the group receiving only lifestyle modification had not changed significantly （ P 〉 0. 05 ）. Conclusion Our study suggests that the abdominal obesity decreases insulin sensitivity, metformin administration together with lifestyle modification can significantly improve insulin sensitivity.