240例男性代谢综合征高危因素人群胰岛功能评价

The Evaluation of Islet Function in 240 Cases of Male with Metabolic Syndrome Risk Factors

评估代谢综合征(MS)高危因素人群胰岛β细胞生理作用情况(分泌,抵抗),为早期预防提供参考依据。2014年3月~2015年3月收集我院体检人群数据,入选240例MS高危男性受试者。通过口服葡萄糖耐量试验和胰岛素刺激试验,空腹及糖负荷后1/2 h和2 h两个时间的的血糖、胰岛素及C肽水平将被观察检测,从而评估胰岛β细胞功能及胰岛素抵抗情况。OGTT结果表明血糖正常组、糖尿病前期组和伴糖尿病组MS患者分别为148例(61.7%)、76例(31.7%)、16例(6.6%)。各组血糖、胰岛素和C肽的体内变化曲线发现各组的指标随着时间慢慢升高后缓慢下降,最后趋于平缓。餐后1/2 h和2 h时间点,发现血糖异常的两组胰岛素及C肽仅I_(2h)、C_(1/2h)及C_(2h)与正常组相比具有一定差异,且C_(1/2h)与正常组相比有下降趋势,I_(2h)、C_(2h)与正常组相比则有所提高。伴糖尿病的MS患者胰岛素抵抗指标HOMA-IR、IAI、ISIc显著高于正常血糖的MS患者。与正常血糖MS患者相比,糖尿病前期MS患者和伴糖尿病MS患者的HBCI、IGI都显著降低。综上所述,MS人群虽然FBG早期未出现紊乱现象,当给予糖负荷后,其血糖发生异常变化,该危险不容忽视。MS患者具有潜在的糖尿病风险,因此,通过探讨MS高危人群的胰岛分泌功能及胰岛素抵抗情况,对早期预防有一定指导价值。

In order to provide reference basis for early prevention, this study evaluated islet beta cells secrete function and insulin resistance of risk factors of metabolic syndrome （MS）. During March 2014 to March 2015, we collected our hospital check-up crowd data and selected 240 cases of MS high-risk male subjects. By oral glucose tolerance test （OGTT） and insulin stimulation test, we measured blood glucose, insulin and C-peptide levels on an empty stomach and sugar load after 1/2 h and 2 h min, and evaluated islet beta cells secrete function and insulin resistance. The OGTT results showed that the normal blood glucose group, pre-diabetes and diabetes group patients with MS were respectively 148 cases （61.7%）, 76 cases （31.7%）, and 16 cases （6.6%）. The blood glucose, insulin and C-peptide curves found that each index in all groups increased as time, then slowed drop, leveled off in the end. At 1/2 h and 2 h after meal, we found I2h, C1/2h and C2h in two groups of abnormal blood sugar were different with the normal group, and C1/2h was lower than the normal group, I2h and C2h were higher than the normal group. HOMA-IR, IAI and ISIc of MS patients with diabetes were significantly higher than normal blood glucose of MS patients. Compared with normal blood glucose in patients with MS, HBCI, IGI of MS patients with pre-diabetes and MS patients with diabetes were significantly reduced. In conclusion, while FBG in early metabolic abnormalities of crowd had not yet occurred disorder, but the abnormal glucose after sugar load rate was higher, which cannot be ignored. Because MS patients has the potential risk of diabetes, it might have certain guiding value for early prevention by discussing MS high-risk groups of insulin secretion and insulin resistance.