生活方式干预对大学生2型糖尿病高危人群胰岛素抵抗的影响

The effect of intervention of lifestyle on insulin resistance among the high-risk students with type 2 diabetes

目的探讨大学生中2型糖尿病高危人群的胰岛素抵抗、空腹血糖水平及生活方式干预效果,为提高相关人群的健康状况提供依据。方法选取沈阳市某高校有2型糖尿病一级亲属非肥胖者40名(Ⅰ组),有2型糖尿病一级亲属合并肥胖者40名(Ⅱ组),无2型糖尿病一级亲属单纯合并肥胖者40名(Ⅲ组),无上述危险因素非肥胖健康自愿者40名(Ⅳ组),进行葡萄糖耐量(OGTT)及胰岛素释放试验,同时进行血脂水平及体质量指数、腰臀比检查,对比四组血脂水平、胰岛素抵抗水平、血糖水平等指标;进行为期1年的生活方式干预治疗,观察各临床指标的变化。结果干预前,与健康组(Ⅳ组)比较,Ⅰ组的CH,TG,LDL-C,Glu0,Glu30,Glu60,Ins30,Ins60,Ins120,HOMA-IR,ΔI30/ΔG30均较高(P值均<0.05);Ⅱ组中除HDL-C降低外,其余指标均较高(P值均<0.05);Ⅲ组中除HDL-C降低外,BMI,WHR,CH,TG,LDL-C均较高(P值均<0.05)。采取生活方式干预后,Ⅰ组除HDL-C升高外,CH,TG,LDL-C,Glu0,Glu120,Ins0,Ins120,HOMA-IR,ΔI30/ΔG30均降低,差异有统计学意义(P值均<0.05);Ⅱ组除HDL-C升高外,其余指标均降低,差异均有统计学意义(P值均<0.05);Ⅲ组除HDL-C升高外,CH,TG,LDL-C,BMI,WHR均降低,差异有统计学意义(P值均<0.05);而健康组的各项指标与干预前相比差异均无统计学意义(P值均>0.05)。结论大学生中2型糖尿病高危人群胰岛素抵抗、空腹血糖的水平均较高,规范化生活方式干预可以有效降低胰岛素抵抗、胰岛素及空腹血糖水平,延缓T2DM的发生发展。

Objective To investigate insulin resistance, the fasting blood glucose level and the interventional effects of lifestyle, and to provide references for improving health of related people. Methods 120 students were selected from a college in Shenyang, among which 40 students with first-degree relatives of type 2 diabetes as GroupⅠ, 40 students with obese first-degree relatives of type 2 diabetes as GroupⅡ, 40 students without obese first-degree relatives of type 2 diabetes as Group Ⅲ, and 40 healthy volunteers without the risk factors above as Group Ⅳ. Glucose tolerance（ OGTT） and insulin releasing secretion test were provided to them performed, Meanwhile blood lipid level, body mass index and waist hip ratio were also researched, index changes including serum lipid levels, insulin resistance, blood glucose level were compared among the four groups; all the changes of the clinical parameters were researched after 1-year interventional treatment. Results Compared with healthy group（ GroupⅣ）, Indexes, including CH, TG, LDL-C, Glu0, Glu30, Glu60, Ins30, Ins60, Ins120, HOMA-IR, ΔI30 / ΔG30, increased（ P〈0.05）; apart from index of HDL-C, all the other indexes of Group II increased（ P〈0.05）; apart from index of HDL-C, the indexes of BMI, WHR,CH,TG, LDL-C increased（ P〈0.05）. after the intervention of lifestyle, apart from HDL-C, all the other indexes in GroupⅠ, including CH, TC, LDL-C, Glu0, Glu120, Ins0, Ins120, HOMA-IR, ΔI30 / ΔG30 decreased. All the differences were of statistical significance（ P〈0.05）; in Group II, apart from HDL-C, all the other indexes decreased. All the differences were of statistical significance（ P〈0.05）. In Group III, apart from HDL-C, the indexes of CH, TG, LDL-C, BMI, WHR were decreased, all the differences were of statistical significance（ P〈0.05）. And the indexes of the health group have not changed significantly. And all the differences are of no statistical significance（ P〈0.05）. Conclusion The high-risk people with type 2 diabetes among college students have a high level of insulin resistance, fasting blood glucose compared to healthy subjects. After standardized lifestyle intervention, insulin resistance, insulin and fasting blood glucose level can be effectively reduced and occurrence and development of T2 DM can be delayed. Therefore, it is worthy of clinical promotion.