肥胖者胰岛素分泌功能对糖耐量低减及糖尿病发生的影响

The effect of insulin secretion function on the development of impaired glucose tolerance and diabetes mellitus in obesity

目的 探讨肥胖者胰岛素分泌变化对糖耐量低减 (IGT)及糖尿病 (DM)发生的影响。 方法 对 30例单纯性肥胖 [体重指数 (BMI) >2 7]患者进行血糖和胰岛素测定 ,并观察胰岛细胞分泌指数 (HOMA- IS)及胰岛素敏感性指数 (IAI) ,并对这些患者进行 15年随访。 结果 肥胖者空腹胰岛素 (FINS)水平明显高于正常人 (P <0 .0 1) ,与 HOMA - IS明显的正相关 (P <0 .0 1) ;空腹血糖(FPG)与 HOMA- IS及 IAI呈明显的负相关 (P<0 .0 1)。15年内 6 3.3%的肥胖者发展成 IGT,5 0 .0 %的肥胖者及发展成 IGT者发展为 2型 DM。 结论 肥胖对 IGT及糖尿病的发生、发展有着明显的影响 ,控制体重是减少 IGT发生的重要环节。

Objective To investigate the effect of insulin secretion function on the development of impaired glucose tolerance (IGT) and diabetes mellitus (DM) in obesity. Methods Plasma glucose and serum insulin were measured by 100 g flour tolerance test and insulin releasing test in 30 cases of non diabetic with normal glucose tolerance (NGT) (BMI>27). They have been followed for 15 years. Insulin secretion index (HOMA IS) and insulin sensitivity index (ISI) was calculated. Results In obese group, the mean fasting serum insulin (FINS) level was significantly higher ( P <0.001) and well positively correlated with HOMA IS( P <0.01). Insulin sensitivity index (ISI) was significant lower ( P <0.01) and negatively associated with Fasting serum glucose (FPG) ( P <0.001). The prevalence of IGT was 63.3% in the obese group, and the prevalence of type 2 DM was 50%. Conclusion Obesity had significant effect on the incidence and development of IGT and DM. Weight control was a key factor in the development of IGT.