代谢异常人群糖耐量与胰岛功能及胰岛素作用的关系

Relationship between glucose tolerance and the functions of pancreatic β-cell and insulin in people with abnormal metabolism

目的探讨不同糖耐量状态的代谢高危人群胰岛功能及胰岛素作用的变化。方法选择体检人群中筛查出无糖尿病史的代谢异常者334例,行口服葡萄糖耐量试验(OGTT)及胰岛素、C肽释放试验,计算胰岛素敏感指数(IAI)、胰岛素抵抗指数(IR)、胰岛素分泌指数(HBCI)和空腹β细胞功能指数(FBCI)。根据OGTT结果分为三组:糖耐量正常(NGT组,218例),糖调节受损(IGR组,93例)和糖尿病(DM组,23例),比较三组人群胰岛功能的变化。结果与NGT组比较,IGR组及DM组腰围、体重指数(BMI)、低密度脂蛋白(LDL)、胰岛素、IR升高,IAI、HBCI降低(P<0.05)。结论随糖耐量状态恶化代谢异常人群高胰岛素血症加重,胰岛素敏感性逐步降低,胰岛细胞功能呈衰退趋势。

Objective To study the relationship between glucose tolerance and the functions of pancreatic β-cell and insulin in people with abnormal metabolism. Methods A total of 334 non-diabetic cases with abnormal metabolism was screened from the subjects underwent medical examination. The oral glucose tolerance test（OGTT） and insulin,C-peptide release test were carried out,and insulin sensitivity index（IAI）,insulin resistance index（IR）,insulin secretion index（HBCI or HOMA-β） and fasting β cell function index（FBCI） were calculated.According to OGTT results,the subjects were categorized into three groups of NGT （218 cases with normal glucose tolerance）,IGR（93 cases with impaired glucose regulation） and DM（23 cases with diabetes mellitus）.Those indices were compared among three groups. Results Compared with group NGT,the waist circumference,BMI,LDL,insulin and IR in groups of IGR and DM were higher,but IAI and HBCI were lower significantly（P0.05）. Conclusion As the glucose tolerance state is decreasing in people with metabolic abnormality,a tendecy of decreased insulin sensitivity and increased damage of pancriatic β-cell function.