空腹血糖受损人群干预后胰岛素抵抗与胰岛β细胞功能的改变

The changes of insulin resistance and pancreatic island function in cases with impaired fasting glucose received different interventions

目的:观察空腹血糖受损者不同方法干预后的胰岛β细胞功能与胰岛素抵抗(IR)的改变情况,探讨空腹血糖受损(impaired fasting glucose,IFG)的发病机制与干预途径。方法:经葡萄糖耐量试验诊断的127例IFG随机分为3组:生活方式干预组(A组)41例,二甲双胍强化组(B组)45例,罗格列酮强化组(C组)41例。A组给予饮食和运动治疗,B组在此基础上加用二甲双胍治疗,C组加用罗格列酮治疗,在研究开始与结束时分别测量记录空腹血糖、2 h血糖、空腹胰岛素、2 h胰岛素,并在结束时复查葡萄糖耐量试验,比较各组胰岛β细胞功能与IR的改变情况。结果:A组的糖尿病转化率26.8%均高于B组和C组的6.7%与7.3%(P<0.05)。A组和B组的IR改善明显。结论:IFG的发病和IR有很大关系,二甲双胍或罗格列酮能更有效地改善IR,并减少IFG向糖尿病转化。

Objective： To investigate the changes of the function of pancreatic island and insulin resistance （IR） in cases with impaired fasting glucose（IFG） received different interventions, nethods：A total of 127 patients with IFG were divided randomly into three groups to be administrated with different interventions： life style intervention group （received dietary therapy and exercise training,n =41 ）, plus metformin group（ received dietary therapy and exercise training and metformin, n = 45 ） and plus rosiglitazone group（received dietary therapy and exercise training and rosiglitazone, n = 41 ）. The body mass index, fasting plasma glucose, 2 h plasma glucose, fasting insulin and 2 h insulin were measured both before and after the interventions. Finally, glucose tolerance tests recheck were and the changes of insulin resistance and pancreatic island function of each group were compared. Results：The rates of transformation of IFG to diabetes mellitus every year in plus metformin group （ 6.7% ） and plus rosiglitazone group （7.3%） were significantly lower than that of life style intervention group （ P 〈 O. 05 ）. There were significantly improvements of insulin resistance in both of the two plus groups. Conclusions：The morbidity of IFG is closely related to the IR. Metformin or rosiglitazone can efficiently improve the IR and reduce the transformation of IFG to diabetes mellitus.