正常体质量伴代谢性肥胖的胰岛功能和胰岛素抵抗的相关研究

RESEARCH IN EFFECTS OF FAT DISTRIBUTION ON INSULIN SECRETION AND INSULIN RESISTANCE IN METABOLIC OBESITY NORMAL-WEIGHT

目的 :研究肥胖 (超重 )和正常体质量者脂肪中心型分布对胰岛细胞分泌功能和胰岛素抵抗 (IR)的多因素影响及防治。方法 :882例参试者根据 BMI和 WHR分成 4组 ,1组 :2 0≤ BMI<2 5并且 WHR≥ 0 .9(男 )或 0 .85 (女 ) ;2组 :2 0≤BMI<2 5并且 WHR<0 .9(男 )或 0 .85 (女 ) ;3组 :BMI≥ 2 5并且 WHR≥ 0 .9(男 )或 0 .85 (女 ) ;4组 :BMI≥ 2 5并且WHR<0 .9(男 )或 0 .85 (女 )。结果 :1组和 2组之间 ,IR、 IAI、 PINS、血糖曲线下面积有显著性差异 ,3组和 4组之间 ,IR、 IAI、 FINS、血糖曲线下面积有显著性差异。多因素逐步回归分析表明 ,仅 TG、 BMI、 UAER三个变量进入 IR和 IAI的回归方程 ,TG、 TCH两个变量能进入 IS、 FINS/ FBG的回归方程。结论 :1影响胰岛细胞分泌和胰岛素抵抗的因素中最重要的两个因素是 BMI和 TG;2 BMI和 WHR对胰岛素抵抗都有影响 ,在肥胖人群中 BMI和 WHR对 IR的影响有双重作用 ,中心型肥胖较之周围型肥胖的 IR更加明显 ,而在正常体质量人群中 WHR的影响占主导地位 ;3正常体质量伴有脂肪中心型分布 (MONW)的人群中 ,可出现类似肥胖人群的代谢变化。

Objective:To investigate effects of fat distribution on insulin secretion (IS) and insulin resistance (IR) in obese (overweight) and no obese subjects Method:882 participants were divided into four groups by body mass index (BMI) and waist hip ratio (WHR) Group1:20≤BMI<25 and WHR≥0 9 (male) or 0 85 (female);group 2:20≤BMI<25 and WHR<0 9 (male) or 0 85 (female);group 3:BMI≥25 and WHR≥0 9 (male) or 0 85 (female);group 4:BMI≥25 and WHR<0 9 (male) or 0 85 (female) Results:IR、IAI、PINS、area beneath glucose curve were higher in group1 than that in group 2 significantly,and IR、IAI、FINS、area beneath glucose curve were higher in group 3 than that in group 4 significantly Stepwise regression analysis was performed Results showed that only BMI and TG entered regression equations about IR and IAI,and TG 、TCH entered regression equations about IS and FINS/FBG Conclusion:①Among many factors which affect IR and IS,including age,weight,BMI,waist,WHR,hypertension,hypertriglyceridemia,hypercholesterolemia and UAER,the most important factors are BMI and TG;②BMI and WHR both affect IR In obese subjects BMI and WHR have multiple effects on IR,and therefore,centric obese subjects have more serious IR than peripheral obese subjects;in no obese subjects,effects of WHR on IR are dominant;③There are similar metabolism changes in subjects with BMI<25 and WHR ≥0 9 or 0 85 (MONW) with that in obese subjects