【摘要】 目的 :测定 2型糖尿病家系血胰岛素和血脂水平 ,了解胰岛功能减退和胰岛素抵抗在 2型糖尿病发病中的作用。方法 :收集 2 1个河南省汉族 2型糖尿病家系一级成年亲属共 2 0 6人 ,其中糖耐量正常者 1 1 8例 (A组 ) ;糖耐量减退 (IGT)者 2 2例 (B组 ) ;糖尿病 (DM)患者 5 0例 (C组 ) ;新诊断糖尿病患者 1 6例 (D组 ) ;无糖尿病家族史且口服葡萄糖耐量试验 (OGTT)正常者 36例为对照 (E组 )。对受试者行OGTT ,并于OGTT 0min ,30min ,6 0min ,1 2 0min ,1 80min行胰岛素和真胰岛素释放试验 ,据此计算胰岛素敏感、抵抗和释放指数 ,并测定血甘油三酯 (Tg) ,胆固醇(Ch) ,低密度脂蛋白 (LDL -C)和高密度脂蛋白 (HDL -C)水平。结果 :A、B、C、D组血LDL -C水平高于E组 ,其中C、D 2组Tg和Ch水平亦高于E组 ;A、B和D组OGTT各时段 (除 30min外 )胰岛素水平及各时段总和均高于E组 ;B、C和D组有免疫胰岛素分泌延迟 ,高峰在餐后 1 2 0min ,而A和E组分泌高峰在 6 0min ;A组葡萄糖刺激后 30min真胰岛素水平及各时段总和低于E组 ,B组OGTT 0min ,30min真胰岛素水平及各时段总和低于E组 ,C和D组OGTT各时段真胰岛素及各时段总和均低于E组 ;B ,C和D组胰岛素敏感性指数及A ,B ,C和D组抵抗指数低于E组。结论 :2型糖尿病家系非糖尿病同更多还原

【Abstract】 Aim:To study the roles of insulin dysfunction and resistance in the pathogenesis of type 2 diabetic families. Methods: Oral glucose tolerance test (OGTT), insulin and true insulin secretion test, blood triglyceride (Tg), cholesterol (Ch), low-density lipoproteins (LDL-C) and high-density lipoproteins (HDL-C) determination were performed in 206 people from 21 type 2 diabetic families consisting of 118 non-diabetic first-degree relative individuals (Group A), 22 patients (Group B) with impaired glucose tolerance, 60 diabetic patients (Group C) diagnosed previously,16 diabetic patients (group D) diagnosed this time. A total of 36 healthy subjects from no diabetic families, normal OGTT were served as normal controls. Results: Levels of blood LDL-C in Group A, B, C, and D were higher than that in Group E, and levels of blood Tg and Ch in Group C and D were higher than those in Group E. Insulin secreting peaked in Group B, C, and D at 120 minute after oral glucose irritation, but peaked at 60 minute in Group A and E. Each level(except that at 30 min at OGTT)and sum of plasma insulin at OGTT in Group A,B and D were respectively higher than those in Group E. At different time points of OGTT true insulin in Group A(only 30 min at OGTT), B,C and D were respectively lower than that in Group E. Sum of plasma true insulin level at OGTT in Group A,B,C and D was respectively lower than that in Group E. ISI in Group B,C, and D and IR in Group A,B,C, and D were respectively lower than those in Group E. Conclusions:Metabolism abnormality of blood lipid, hyperinsulinemia, and insulin resistance were found in non-diabetic first-degree relative individuals from type 2 diabetic families. Both insulin resistance and islet dysfunction occur in patients with impaired glucose tolerance. Critical islet dysfunction happens in all diabetic patients.更多还原