口服葡萄糖耐量试验仅1小时高血糖人群的β细胞功能

The beta-cell function of subjects with combined normal glucose tolerance(NGT) and 1-hour hyperglycaemia

目的研究OGTT 1h高血糖人群的β细胞功能。方法将1 177例受试者分为正常糖耐量(NGT)、糖调节受损(IGR)和糖尿病(DM)三组。前两组再依据OGTT 1hPG水平分为NGTN、NGT1H和IGRN、IGR1H四个亚组。将IGR组再分为空腹血糖受损(IFG)组和糖耐量受损(IGT)组以及IFG+IGT组。HOMA-IR评估胰岛素敏感性,HOMA-β、AI_(30)/△G_(30)(IGI)、葡萄糖OGTT曲线下面积(AUCg)评估胰岛β细胞分泌功能。结果 (1)NGTN和IGRN组分别比NGT1H和IGR1H组的IGI高(P<0.05);HOMA-IR、AUCg在两亚组间均无统计学差异。(2)NGT1H组比IFG组和IGT组具有较高的AUCg,其HOMA-β比IFG组高,三组间HOMA-IR和IGI差异无统计学意义。结论 NGT1H人群已存在胰岛β细胞功能异常,可能为胰岛素分泌缺陷尤其是早期相分泌受损所致。

Objective To investigate the beta-cell function of NGT subjects with a 1-hour plasma glucose ≥11. 1 mmol/L in Chinese Han population. Methods Based on the results of OGTT, 1177 subjects were classified into three groups： NGT, IGR and DM. Then according to the level of 1-hour plasma glucose, sub-groups included NGT with normal lh OGTT glucose Ievel（NGTN） and NGT with high l hOGTT gluoose level（NGT1H）; IGRN and IGR1H. Insulin resistance was estimated using the homeostasis assessment of IR（HOMA-IR）, and pancreatic β-cell function was evaluated by HOMA-β, △I20/△G30（IGI）and AUCg. Results （1） The IGI of NGTIH and IGR1H was lower than NGTN and IGRN,respeetively （P〈 0.05）. No differences in HOMA-IR and AUCg were found between NGTN and NGT1H, IGRN and IGR1H. （2） No statistical significant differences were found in IGI and HOMA-IR among NGT1H,IGT,IGR and CGI. The HOMA-β of the NGT1H group was similar to the IGT group. Conclusions Chinese NGT1 H subjects are characterized by glucose metabolic abnormalities, which may be caused by the impairment of early insulin release.