【摘要】 目的探讨正常糖耐量与糖代谢异常人群的胰岛β细胞功能和胰岛素抵抗及与血糖、血脂等因素的关系。方法2005年北京某大学体检空腹血糖(FPG)≥5.6mmol/L共有1519人,其中有617人(40.62%)行口服葡萄糖耐量试验(OGTT)试验,并检测空腹胰岛素(FINS)、甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、尿素氮(BUN)、肌酐(Cr)和餐后2hPG、胰岛素(PINS)以及测量身高、体重、腰围、臀围和血压,计算胰岛素抵抗指数(HOMA-IR)和胰岛β细胞功能(HOMA-β)及体质指数(BMI)。结果617人中查出正常糖耐量(NGT)374人(60.62%),空腹血糖受损(IFG)60人(9.72%),糖耐量受损(IGT)59人(9.56%),IFG+IGT41人(6.65%),糖尿病83人(13.45%)。NGT、IFG、IGT、IFG+IGT、糖尿病组年龄、BMI和腰臀比平均值递增;随着BMI增加,糖尿病检出率明显增加;IFG、IGT、IGT+IFG、糖尿病组的HOMA-IR均高于NGT组(P<0.001);糖尿病组HOMA-β低于NGT、IFG、IGT+IFG组(P<0.001)。HOMA-IR与BMI(r=0.275,P<0.001)、腰臀比(r=0.148,P<0.001)、FPG(r=0.304,P<0.001)、2hPG(r=0.276,P<0.001)、TG(r=0.144,P<0.001)、TC(r=0.048,P<0.05)、LDL-C(r=0.101,P<0.05)相关;HOMA-β与年龄(r=-0.095,P<0.05)、BMI(r=0.197,P<0.001)、腰臀比(r=0.086,P<0.05)、FPG(r=-0.224,P<0.001)、2hPG(r=-0.085,P<0.001)相关。结论该人群中糖代谢异常达到40%。IFG、IGT阶段已经存在明显的胰岛素抵抗,新发糖尿病患者,即存在胰岛素抵抗,又存在明显胰岛素分泌功能低下。β细胞的功能的减退和胰岛素抵抗与BMI、腰臀比、血糖、血脂均相关。更多还原

【Abstract】 Objective To investigate the prevalence rates of diabetes, impaired fasting glucose (IFG), impaired glucose tolerance (IGT) and related factors in the university staff. Methods 617 subjects were selected from 1 519 cases with the fasting blood glucose level ≥5.6 mmol / L in the annually physical examination among 3 851 population in a university community. All 617 subjects were taken the blood glucose and insulin test for the fasting and 2 hour after 75 g glucose intake. The fasting lipids, BUN and Cr were determined. The demographic data including height, weight, waist circumference and blood pressure was also collected. Results The numbers of normal glucose tolerance (NGT), IFG, IGT, IFG+IGT and newly diagnosed DM were confirmed in 374 (60.62%), 60 (9.72%), 59 (9.56%), 41 (6.65%) and 83 (13.45%); totally, 243 (39.38%) cases with abnormal glucose metabolism. The highest DM prevalence was found in the group with BMI ≥28 kg / m2. In the group with hypertriglyceridemia, prevalence of DM, IFG and IFG +IGT was 12.50%, 8.33% and 8.33%. In the group with hypercholesteremia and hypertriglyceridemia together, prevalence of DM, IFG+IGT, IFG and IGT was 18.87%, 7.17%, 11.32% and 12.83%. DM prevalence increased with the higher triglycerides level. No differences of HOMA-IR was found among groups of DM (0.80±0.82), IFG (0.64±0.72), IFG+IGT (0.61±0.77), IGT (0.35±0.68), but all these obviously higher than that of NGT group (0.17±0.80). No differences of HOMA-B among the IGT (3.97±0.69), NGT (3.95±0.78), IFG (3.84±0.72), IFG+IGT (3.80±0.78) groups, but all these higher than that of NGT(3.69±0.88)group. Conclusion About 40% of these subjects in the university population had their blood glucose ≥5.6 mmol/L. In these subjects with blood glucose ≥5.6 mmol/L, about 40% of them had abnormal blood glucose level, including 13.45% diabetic patients. The highest prevalence of IFG, IGT, IFG+IGT was found in the group aged 60～70, the highest prevalence of DM in the group aged 70～80 and increased paralleled with the BMI and aging, was associated with lipids disorder, particularly with hypertriglyceridemia. IR existed in the pre-diabetes state and was worst in the DM, with most severe β cell function failure.更多还原