糖耐量正常的2型糖尿病一级亲属胰岛素敏感性与腹脂分布的相关性

Correlation between insulin sensitivity and visceral fat in normal glucose tolerance first degree relatives of type 2 diabetes patients

目的了解糖耐量正常的2型糖尿病一级亲属人群腹内脂肪面积(VA)与胰岛素敏感性的关系。方法将糖耐量正常的2型糖尿病一级亲属按HOMR-IR划分为胰岛素敏感组(IS组)和胰岛素抵抗组(IR组)。分别测定血脂、血糖、胰岛素、体重指数(BMI)、腰围(WC)、VA和腹部皮下脂肪面积(SA),计算VA/SA值和TA(腹部脂肪总VA+SA,稳态模型胰岛素抵抗指数来评估胰岛素敏感性。结果IR组空腹TG、VLDL较IS组有升高趋势,但无统计学意义(P>0.05);糖负荷后2h后,IR组TG、VLDL、ApoB明显升高,均有统计学意义(P<0.05或P<0.01)。IR组30min血糖、60min血糖明显升高,有统计学意义(P<0.01)。腰围、VA、VA/SA、TA在IR组显著高于IS组,有统计学意义(P<0.01)。多元回归分析显示VA是胰岛素敏感性的独立相关因素。结论胰岛素抵抗组在糖耐量正常阶段已经出现脂代谢、糖代谢异常和腹内脂肪增多。

Objective To study the correlation between insulin sensitivity（IS） and visceral fat in normal glucose tolerance （NGT） first degree relatives （FDRs） of T2DM patients. Methods NGT FDRs of 32DM patients were divided into IS and insulin resistance （IR） groups. The levels of blood fat, blood glucose, insulin, body mass index （BMI）, waist circumference （WC）, visceral adiposity （VA） and subcutaneous fat area （SA） were measured, and IS was evaluated by HOMA-IR. Results The levels of TG, VLDL-C and ApoB at 120 min after OGTT were significantly higher in IR group than those in IS group （ P 〈 0. 05, P 〈 0. 01 ）. The levels of blood glucose at 30, 60 rain after OGTT were higher in IR group than those in IS group （P 〈0. 01 ）. WC, VA, VA/SA and TA of IR group were higher than those of IS group （ P 〈 0. 01 ）. VA was independent risk factor of IS by multiple regression analysis. Conclusions IR patients have the appeared abnormal lipid metabolism and glycometabolism and increased visceral fat in NGT stage.