【摘要】 目的:探讨肥胖对不同糖耐量人群第一时相胰岛素分泌功能的影响。方法:无糖尿病家族史的正常糖耐量者(正常对照,NC)38例、2型糖尿病一级亲属正常糖耐量(NGT)者32例、糖调节受损(IGR)者67例及新诊断的2型糖尿病(T2DM)患者35例参与本试验。这4个组再分为超重/肥胖及正常体重2个亚组。各组均行静脉葡萄糖耐量试验(IVGTT)和口服葡萄糖-胰岛素释放试验(OG-IRT),计算第一时相胰岛素分泌功能指数(AlR3-5)及胰岛素敏感性指数(ISI),分析肥胖对不同糖耐量人群胰岛β细胞功能及胰岛素抵抗的影响。结果:NC超重/肥胖亚组较正常体重亚组AIR3-5显著升高(P<0.05),其余3对亚组间比较差异均无统计学意义(均P>0.05)。超重/肥胖亚组ISI较正常体重亚组有降低趋势,其中IGR两亚组间比较差异无统计学意义(P>0.05),其余3对亚组间比较差异均有统计学意义(均P<0.05)。ISI与体重指数和腰围在各组均呈负相关(P<0.05),与AIR3-5在NC组呈负相关(P<0.05),而在其余各组均呈正相关(均P<0.05)。结论:肥胖对不同糖耐量人群胰岛β细胞分泌功能影响各不相同。无糖尿病家族史的正常糖耐量者随着胰岛素抵抗的加重,第一时相胰岛素分泌功能代偿性增加,而2型糖尿病一级亲属正常糖耐量者、糖调节受损者和2型糖尿病患者则不能代偿性增加。更多还原

【Abstract】 AIM: To explore the influence of obesity on the first-phase insulin secretion in the individuals with different glucose tolerance.METHODS: Thirty-eight subjects with normal glucose tolerance without family history of diabetes(normal control,NC),32 subjects with normal glucose tolerance(NGT) who were the first-degree relatives of type 2 diabetic patients,67 patients with impaired glucose regulation(IGR) and 35 newly-diagnosed type 2 diabetic patients(T2DM) were enrolled in the study.The patients in the 4 groups were further divided into 2 subgroups: overweight/obesity and normal weight subgroups.All subjects received oral glucose-insulin release test(OG-IRT) and intravenous glucose tolerance test(IVGTT).Acute insulin response at 3~5 min(AIR3-5) was used to reflect first-phase insulin secretion,and insulin sensitivity index(ISI) was used to reflect insulin sensitivity.The influence of obesity on the islet β-cell function and insulin sensitivity in the individuals with different glucose tolerance was observed.RESULTS: The level of AIR3-5 in NC overweight/obesity subgroup was significantly higher than that in normal weight subgroup(P<0.05),while there was no significant difference between other subgroups(P>0.05).No significant difference in the level of ISI between the patients of IGR in overweight/obesity subgroup and normal weight subgroup was observed,while in the other 3 overweight/obesity subgroups,ISI was lower than that in normal weight subgroups(P<0.05).ISI was negatively correlated with body mass index and waist circumference in all groups(P<0.05).ISI was also positively correlated with AIR3-5 in NC group and negatively correlated in the other 3 groups(P<0.05).CONCLUSION: The impact of obesity on insulin secretion is not the same in the subjects with different glucose tolerance.With the aggravation of insulin resistance,the first-phase insulin secretion in the subjects with normal glucose tolerance without family history of diabetes increases for compensation,while that in the normal glucose tolerance subjects who are the first-degree relatives of type 2 diabetic patients,the patients with impaired glucose regulation and the type 2 diabetic patients could not increase for compensation.更多还原