【摘要】 目的　探讨中国人不同糖耐量状态下的葡萄糖兴奋胰岛素分泌的特点。方法　 6 34例受试者分成两类亚组 :1、以体块指数 (BMI) 2 5为切割点 ,分为正常体重组 (NW )与超重 /肥胖组 (OW /OB) ,并按空腹血糖水平的不同各分为 7个亚组。 2、根据BMI和糖耐量 ,把所有受试者分为以下 6个亚组 :正常体重 正常糖耐量组(NW NGT)、正常体重 空腹血糖减损 /糖耐量减退组 (NW IFG/IGT)、正常体重 糖尿病组 (NW DM )、超重 /肥胖 正常糖耐量组 (OW /OB NGT)、超重 /肥胖 空腹血糖减损 /糖耐量减退组 (OW /OB IFG/IGT) ,及超重 /肥胖 糖尿病组 (OW /OB DM)。以口服葡萄糖耐量试验 (OGTT) 0～ 12 0min的平均胰岛素水平评价葡萄糖兴奋的胰岛素分泌功能 ,采用稳态模式评估法 (HOMA)评价胰岛素抵抗 (HOMA IR)。结果　 1、中国人空腹血糖与总体胰岛素分泌呈倒U字型曲线 ,正常体重者中总体胰岛素分泌高峰的空腹血糖值为 5 .9mmol/L ;2、超重 /肥胖伴正常糖耐量的个体总体胰岛素分泌最高 ;3、超重 /肥胖个体伴IGT时 ,总体胰岛素分泌减退 ,并伴胰岛素抵抗指数升高 ;4、超重 /肥胖伴糖尿病时 ,同时存在进行性的总体胰岛素分泌功能的减退及胰岛素抵抗指数的持续升高。结论　 1、中国人空腹血糖与总体胰岛素分泌呈倒U字型曲线 ,高更多还原

【Abstract】 Objective To investigate the glucose stimulated insulin secretion under various glucose tolerant status among Chinese individuals. Methods 634 individuals were included. Individuals were classified as: 1.Normal weight group (NW) and over weight/obese (OW/OB) group according to the obesity criteria of WHO 1998. Both groups were further divided into 7 subgroups on the basis of fasting glucose levels. 2. 6 subgroups according to body mass index (BMI) and glucose tolerant status: NW with normal glucose tolerance (NGT) (NW NGT), NW with imparied fasting glucose/impaired glucose tolerance (IFG/IGT) (NW IFG/IGT), NW with diabetes(DM) (NW DM), OW/OB with NGT(OW/OB NGT), OW/OB with IFG/IGT (OW/OB IFG/IGT), OW/OB with DM (OW/OB DM). The mean insulin concentration during 2 hour OGTT was applied for estimating glucose stimulated insulin secretion. Homeostasis model assessment was used to assess the degree of insulin resistance. Results 1.The relationship between glucose stimulated insulin secretion and fasting glucose concentration was similar to an inverted U shaped curve. The glucose stimulated insulin secretion reached the peak at fasting glucose level of 5.9mmol/L in normal weight subjects. 2.The highest level of the glucose stimulated insulin secretion was observed in overweight or obese individuals with NGT. 3. In overweight or obese individuals with IGT, there was a decrease in glucose stimulated insulin secretion and increased HOMA IR. 4.Overweight or obese individuals with DM were related to a further decrease in glucose stimulated insulin secretion and worsening of the insulin resistance. Conclusion 1.Among the Chinese individuals, the relationship between glucose stimulated insulin secretion and fasting glucose concentration was similar to an inverted U shaped curve. The peak of the curve was forwardly shifted more than that seen the Caucasians. The fasting glucose concentration was lower than that of the Caucasians when glucose stimulated insulin secretion reached the peak. In the subgroups of NGT, IFG/IGT and DM, they were associated with progressive decrease in glucose stimulated insulin secretion and rise in insulin resistance in overweight or obese Chinese individuals.更多还原