高甘油三酯并糖调节异常及正常者的胰岛素抵抗及胰岛素分泌的研究

The study of insulin resistance and insulin secretion in patients of impaired glucose regular and normal glucose tolerance with elevated triglyceride

目的:了解高甘油三酯并糖调节异常(IGR)[包括空腹血糖受损(IFG)或/和糖耐量减低(IGT)者]及正常(NGT)者的胰岛素抵抗及胰岛素分泌。方法:在体检人群中筛选出高甘油三酯并IGR及NGT者62人及健康者14人为研究对象,测血压、身高、体重、腰围、臀围,计算体重指数(BMI)及腰臀比(腰/臀)。经口服葡萄糖耐量试验(OGTT)测血糖(PG),同时检测甘油三酯(TG)及真胰岛素(TINS)、胰岛素原(PINS),根据血糖和TG结果将研究对象分为四组。①组(健康对照组):为NGT和TG正常者14人,②组(NGT+HTG):为NGT而高TG者即20人,③组(IFG/IGT+HTG):IFG或IGT伴高TG者23人,④组(IFG+IGT+HTG):IFG并IGT伴高TG者19人,四组均排除高血压病、肥胖及其它疾病。根据稳态模型公式计算各组的胰岛素抵抗指数(HOMA-IR),HOMA胰岛β细胞功能指数(HOMA-β),胰岛素快速反应指数(AIR)。结果:四组的BMI、腰/臀,真胰岛素,胰岛素原水平呈现①②③④组依次递增的趋势,③④组的HOMA-IR有别于①②组,四组的HOMA-β依次递减,差异均有显著性,P【0.05~0.000。结论:高甘油三酯并IGR及NGT者已出现胰岛素抵抗、胰岛素分泌及胰岛β细胞功能变化。

Objective To study the insulin resistance and insulin secretion in patients of impaired glucose regular (IGR)[including impaired fasting glucose(IFG) or/and impaired glucose tolerance(IGT)]and normal glucosetolerance (NGT) with elevated triglyceride. Method: In persons of physical examination,62 cases of IGR and NGT with elevated triglyceride and 14 cases of health were chosen as objects of study. Blood pressure,body height, weight ,waist circumference and buttocks circumference was measured and body weight index (BMI),ratio of waist to buttocks was calculated. Blood-glucose,triglyceride and true insulin (TINS),proinsulin (PINS) were tested through oral glucose tolerance test (OGTT). According to blood-glucose and triglyceride,the objects of study were divided into four groups. ① group (health control group): 14 cases of NGT and normal triglyceride,② group(NGT+HTG): 20 cases of NGT and elevated triglyceride,③ group(IFG /IGT+HTG): 23 cases of IFG or IGT with elevated triglyceride,④ group (IFG +IGT+HTG): 19 cases of IFG and IGT with elevated triglyceride. Hypertension,obesity and other diseases was excluded from four groups. Insulin resistance index (HOMA -IR),beta-cell function index (HOMA-β) and acute insulin reaction(AIR)was calculated according to Homeostasis model assessment. Result: BMI,ratio of waist to buttocks ,true insulin and proinsulin of four groups are increased one by one from ① group to ② group to ③ group then ④ group. Insulin resistance of ③④ group is different from ①② group,HOMA-β of four groups is decreased one by one,their difference is obvious,P<0.05~0.000. Conclusion: The insulin secretion ,Insulin resistance, HOMA-β of IGR and NGT with elevated triglyceride has changed already.