糖调节受损人群胰岛素早期分泌相的变化及影响因素

Change of first-phase insulin secretion and its influencing factor in impaired glucose regulation individuals

目的探讨糖调节受损人群胰岛素早期分泌相的变化及影响因素。方法整群抽取1024名作为研究对象，所有研究对象均测量腰围、行口服葡萄糖耐量试验。根据口服葡萄糖耐量试验结果对糖耐量状态进行分组：糖耐量正常组、空腹血糖受损组、糖耐量低减组、空腹血糖受损伴糖耐量低减组、糖尿病组。计算早期胰岛素分泌指数。结果与糖耐量正常组1．96±1．03比较，空腹血糖受损组1．79±0．91（P=0．007）、糖耐量低减组1．81±0．97（P=0．007）、空腹血糖受损伴糖耐量低减组1．59±0．85（P=0．005）、糖尿病组1．30±0．60（P=0．004）早期胰岛素分泌指数逐渐下降。Logistic回归分析显示腰围是早期胰岛素分泌指数的重要影响因素（β=0．716，P=0．000）。结论在糖调节受损阶段，早期胰岛素分泌指数已明显下降，腰围可作为评估早期胰岛素分泌指数的指标。

Objective To investigate the change of the first-phase insulin secretion in impaired glucose regulation and its influencing factors. Methods The investigation was performed in 1024 subjects who were se lected by cluster sampling. The body waist circumference （WC） was examined in these subjects. Oral glucose tolerance test was performed, and fasting plasma glucose, fasting insulin as well as 30-, 60-, and 120-minute plasma glucose and insulin after glucose intake were also tested. All the 1024 subjects were divided into 5 groups based on the results of oral glucose tolerance test ： normal glucose tolerance group, impaired fasting glu cose group, impaired glucose tolerance group, impaired fasting glucos/impaired glucose tolerance group, and diabetes mellitus group. First-phase insulin secretion index （ the ratio of change in insulin to change in glucose during the first 30 minutes after glucose ingestion was calculated. Results Compared with normal glucose tol erance group （ 1.96 ±1.03 ） , the first-phase insulin secretion index significantly decreased in the impaired fast ing glucose group （ 1. 79 ± 0. 91 ） （ P = 0. 007 ） , the impaired glucose tolerance group （ 1.81 ± 0. 97 ） （ P = 0. 007 ） , the impaired fasting glucose / impaired glucose tolerance group （ 1.59 ± 0. 85 ） （ P = 0. 005 ） , and the diabetes mellitus group （1.30 ± O. 60 ） （P = 0. 004 ）. Logistic regression analysis showed that WC was the strongest influencing factor of first-phase insulin secretion （β = 0. 716, P =0. 000）. Conclusions The first phase insulin secretion index has already dropped in the stage of impaired glucose regulation. WC can be a use ful indicator for evaluating first-phase insulin secretion.