对正常糖耐量、糖耐量减低、糖尿病胰岛功能及胰岛素抵抗指数的观察

Changes of islet β-cell function in three groups of normal glucose tolerance (NGT), impaired glucose tolerance(IGT) and type 2 diabetes(DM)

目的 正常糖耐量 (NGT)、糖耐量减低 (IGT)及初诊的 2型糖尿病 (DM)胰岛功能及胰岛素抵抗参数的比较。 方法 对 4 4例 NGT(对照组 )、76例 (IGT)和 86例 (DM)测定空腹血糖(FPG)、空腹胰岛素等参数 ,用 FPG和 FINS乘积的倒数计算胰岛素敏感性指数 (IAI)、胰岛素抵抗指数 (IR)和胰岛素分泌指数 [Hom aβ细胞功能指数 (HBCI)和空腹 β细胞功能指数 (FBCI) ],三组间进行统计学比较。 结果 三组间体重指数 (BMI)分别为 (2 4 .0± 3.3) ,(2 4 .6± 2 .9) ,(2 4 .6± 2 .7) kg/m2 ,差异无显著性 (P>0 .0 5 )。而 IAI分别为 - 3.8± 0 .8,- 4 .0± 0 .8,- 4 .4± 0 .8,经方差分析 ,差异无显著性 (P>0 .0 5 )。 IR分别为 1.1± 0 .3,1.3± 0 .6 ,1.6± 0 .5 ,差异有显著性 (P<0 .0 5 )。 FBCI分别为 2 .4± 0 .9,1.9± 0 .7,1.5± 0 .3,差异有显著性 (P<0 .0 0 1)。 HBCI分别为 5 .0± 0 .4 ,4 .4±0 .5 ,4 .0± 0 .6 ,差异有非常显著性 (P<0 .0 0 1)。 结论 IGT到初诊 2型糖尿病 ,胰岛素抵抗有逐渐加重、胰岛素分泌逐渐恶化趋势。

Objective To research the development of insulin resistance and changes in islet β cell function in the process of type 2 diabetes from NGT through IGT to clinic diabetes. Method 44 subjects of NGT,76 subjects of IGT and 86 new diagnosed patients with type 2 diabetes (DM) were observed. Their fasting plasma glucose (FPG) and fasting plasma insulin (FINS) were determined. On the basis of FPG and FINS, insulin secretion function (including Homa β cell function index HBCI and fasting β cell function index FBCI) and insulin resistance level(including Homa model insulin resistance index IR and insulin action index IAI) were calculated. Some compares in statistics were done among the three groups. Results There were not significant differences in IAI and body mass index (BMI) among the three groups ( P >0.05). Other indexes value are as follows: IR 1.1±0.3(NGT),1.3±0.6 (IGT) and 1.6±0.5 (DM), P <0.05; FBCI 2.4±0.9(NGT), 1.9±0.7(IGT) and 1.5±0.3(DM), P <0.001; HBCI 5.0±0.4(NGT),4.4±0.5(IGT) and 4.0±0.6(DM), P <0.001. Conclusion Review 3 groups, mate insulin resistance level rises continuously from NGT, IGT to type 2 diabetes. In contrast, insulin secretion function, HBCI and FBCI, goes down gradually, especially in stage of IGT.