肥胖对2型糖尿病胰岛素敏感性及其代谢异常的影响

ANALYSIS OF THE IMPACT OF OBESITY ON INSULIN-SENSITIVITY AND METABOLIC ABNOMALITY IN TYPE 2 DIABETES MELLITUS

目的 :研究肥胖对 2型糖尿病胰岛素敏感性及其代谢异常的影响。方法 :以体重指数 (BMI)≥ 2 5 kg/ m2 为肥胖 ,<2 5 kg/ m2 为非肥胖作为标准 ,将 2 36例 2型糖尿病分为肥胖组 136例及非肥胖组 10 0例。每例病人均行葡萄糖耐量试验(OGTT) ,同时行胰岛素及 C肽释放试验 ,计算出胰岛素敏感指数及胰岛素抵抗指数。结果 :肥胖与非肥胖组的各时点血糖值均明显增高 ,两组间差异无显著性 (P >0 .0 5 )。肥胖组胰岛素、C肽水平高于非肥胖组 ,其中 0 ,2 ,3h差异有高度显著性 (P <0 .0 1) ;肥胖与非肥胖组比较 ,前者胰岛素敏感指数降低 ,胰岛素抵抗指数增高。同时伴有高血压、血脂异常肥胖组亦明显高于非肥胖组。结论 :肥胖糖尿病患者比非肥胖糖尿病患者胰岛素敏感指数降低 ,胰岛素抵抗指数增高 ,高胰岛素血症显著 ,代谢异常发生率高。

Objective:To investigate the relationship between obisity and insulin sensitivity and metabolic abnormality in type 2 diabetes mellitus Methods:236 cases of type 2 diabetes mellitus were divided into 2 groups:obese group 136,with body mass index (BMI)≥25 kg/m\+2;non obese group 100, BMI<25 kg/m\+2 Oral glucose tolorence test OGTT,insulin and connecting peptide (CP) releasing test were performed in all cases,and insuline sensitivity index and resistant index were calculated for statistic analysis Results:The glucose levels at each time point were both markedly increased in two groups,but there were no significant differences between the two groups Insulin and connecting peptide (CP) level is higher in obese group than in nonobese group There are significant differences in 0 hour,2 hour,3 hour levels(P<0 01) The obese group shows decreased insulin sensitivity, increased insulin resistant index and more complications of hypertetion and lipid abnormolity Conclusion:Obese diabetes patients show decreased insulin sensitivity index, higher incidence of hyper insulinemia and metabolic abnormality as well