不同文化程度糖耐量正常人群血糖及胰岛功能的研究

Study of Glucose and Insulin Secretion Function in People with Normal Glucose Tolerance with Different Educational Background

目的研究不同文化程度的糖耐量正常人群血糖、胰岛功能情况,探讨文化程度与血糖及胰岛素抵抗的相关性。方法电话联系2007年1月-2011年1月体检空腹血糖正常人群,进一步行口服葡萄糖耐量试验及胰岛功能检测,完成相关检查且糖耐量正常者340人,据文化程度分为高文化程度组(n=92)、中等文化程度组(n=194)、低文化程度组(n=54),询问相关病史,测量血糖、血脂、胰岛素等指标,计算胰岛素敏感指数(HOMA-S)、胰岛素抵抗指数(HOMA-IR)、β细胞分泌指数(HOMA-β),并比较3组间的差异。结果随着文化程度的下降,空腹血糖、体质量指数(BMI)、空腹胰岛素、餐后胰岛素、HOMA-β、HOMA-IR逐渐升高,而HOMA-S逐渐下降。其中高文化程度组BMI、空腹胰岛素水平、HOMA-IR低于低文化程度组,中等文化程度组BMI、HOMA-IR显著低于低文化程度组,差异均有统计学意义(P<0.05)。以空腹血糖为因变量行回归分析显示空腹血糖与文化程度、年龄、BMI相关(P<0.05)。结论随着文化程度的下降,BMI升高,HOMA-S下降,HOMA-IR升高,提示在糖耐量正常不同文化程度人群中,已经出现糖代谢及胰岛功能的差异,预示在低文化程度人群中未来发展为糖尿病的比例升高。

Objective To explore the levels of serum glucose and insulin secretion function in people with different educational background of normal glucose tolerance and to investigate its relationship with educational levels. Methods We had telephone connections with normal fast glucose people who did health examination from January 2007 to January 2011, then the 75 g oral glucose tolerance test was performed and the level of insulin were measured. A total of 340 people with normal glucose tolerance who completed our examination and answered a questionnaire on lifestyle were included in our study. They were divided into three groups according to their educational levels. The levels of plasma glucose and insulin were measured in 92 high educational level participants, 68 middle educational level participants and 70 low educational level participants. We calculated homevstasis model assessment（HOMA）-S, HOMAIR, and HOMA-β and compared differences between the three groups. Results With the decline of educational levels, fasting plasma glucose, body mass index（BMI）, fasting insulin, postprandial insulin, HOMA-β, and HOMA-IR gradually increased, while HOMA-S gradually decreased. The level of BMI, fasting insulin and HOMA-IR in high educational level group were significantly lower than those in low educational level group. The level of BMI, HOMA-IR in middle educational level group were significantly lower than those in low educational level group（P〈 0.05）. Correlation analysis indicated that level of fasting plasma glucose was related to age, BMI, and educational levels. Conclusion With the decline of educational levels, BMI and HOMA-IR increase, and HOMA-S decreases, which indicates that they already have differences in glucose metabolism and insulin secretion function in people with normal glucose tolerance, presaging that in the future the proportion of development of diabetes in the low educational level may increase.