中心性肥胖对老年新诊断2型糖尿病患者糖代谢及脂代谢的影响

Effect of central obesity on glucose and lipid metabolism in newly diagnosed elderly patients with type 2 diabetes

目的探讨中心性肥胖对老年新诊断2型糖尿病患者血糖、血脂、游离脂肪酸(FFA)代谢以及胰岛素抵抗和胰岛β细胞分泌功能的影响。方法选取老年新诊断2型糖尿病患者90例,按照腰围(WC)(男性WC≥90cm,女性≥80cm)将所有研究对象分为中心性肥胖组和对照组,测定身高、体质量;所有研究对象均接受口服葡萄糖耐量实验(OGTT),测定OGTT过程中0min、30min、60min、120min、180min的血糖、胰岛素(INS)、C肽(CP)、FFA水平,留取空腹血测定血脂全套,包括总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDLC)、低密度脂蛋白胆固醇(LDL-C)。采用HOMA-IR和HOMA-β分别评价胰岛素抵抗和胰岛β细胞分泌功能。比较2组之间上述指标的差异。结果老年新诊断2型糖尿病患者中心性肥胖组的空腹血糖、HOMA-IR、空腹FFA水平高于对照组(P<0.05)。结论中心性肥胖对于老年新诊断2型糖尿病患者的糖代谢及脂代谢有影响,中心性肥胖者血糖水平高、血脂代谢紊乱,胰岛素抵抗严重。

Objective To investigate the effect of central obesity on the glucose, blood lipid, FFA, blood pressure, insulin resistance and function of islet β cell in newly diagnosed elderly patients with type 2 diabetes. Methods Ninety newly diagnosed elderly patients with type 2 diabetes were selected randomly. They were divided into central obesity group and control group, and all the subjects received oral glucose tolerant test. During the test, the levels of insulin, C-peptide, FFA at the time of 0, 30, 60, 120, 180 min were detected. All patients received the measurement of blood lipid. HOMA-IR was applied to assess the status of insulin resistance, and HOMA-β was used to evaluate the basic function of islet β cells respectively. Results The levels of fasting blood glucose, FFA and HOMA-IR were higher in central obesity group than those in control group. Conclusions Central obesity has adverse effect on glucose and lipid metabolism in newly diagnosed elderly patients with type 2 diabetes.