文档介绍：2型糖尿病患者一级亲属正常糖代谢人群胰岛素抵抗分析
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作者:荆爱玉,李秀丽,谢璇,张春虹,成淑英,袁晓红
【摘要】目的探讨2型糖尿病(T2DM)患者糖耐量正常的一级亲属胰岛β细胞功能及胰岛素抵抗情况,并分析胰岛素抵抗的相关因素。方法选取T2DM患者糖耐量正常的一级亲属63例,根据胰岛素抵抗指数分为胰岛素抵抗组及非抵抗组;选取30例健康体检者作为正常对照组。对所选的93例对象进行血压、血糖、胰岛素、血脂的测定,并计算稳态模型胰岛素抵抗指数(HOMA-IR)及胰岛β细胞功能指数(HOMA-β)。结果①糖尿病患者一级亲属组与对照组相比,胰岛素水平、HOMA-IR、HOMA-β明显升高();②胰岛素抵抗组体质指数、舒张压、甘油三酯、餐后血糖、HOMA-β明显高于胰岛素非抵抗组();③相关分析示胰岛素抵抗与体质指数、舒张压、甘油三酯、餐后胰岛素呈正相关(,),与空腹血糖、餐后血糖、空腹胰岛素、收缩压、胆固醇无显著相关性()。结论 T2DM患者一级亲属存在胰岛β细胞代偿性的高分泌,早期已经出现胰岛素敏感性的下降和胰岛素抵抗。胰岛素抵抗与体重增加、舒张压升高及甘油三酯的升高有关。提示对糖尿病患者一级亲属应严格控制体重、血压及血脂,对减少T2DM具有积极意义。
【关键词】 2型糖尿病一级亲属胰岛素抵抗
ABSTRACT: Objective To investigate the insulin resistance and islet β-cell function in normal glucose tolerance first-degree relatives of type 2 diabetes mellitus (T2DM), and analyze the correlation factor of insulin resistance. Methods According to the HOMA-IR, 63 normal glucose tolerance subjects were divided into two groups: insulin resistance (IR) group and non-insulin resistance (NIR) group. There were 30 healthy persons in the normal control group (NC). We detected the levels of plasma glucose, insulin, blood fat and blood pressure, calculated the insulin resistance index (HOMA-IR) and pancreatic island β cell function index (HOMA-β) by HOMA model in the 93 subjects. Results ① Compared with those in normal control group, the levels of insulin, HOMA-IR and HOMA-β were significantly increased in diabetic first-degree relatives group (). ② Compared with those in negative insulin resistance group, the levels of BMI, diastolic blood pressure, triglyceride, two-hour postprandial plasma glucose and HOMA-β were significantly increased in insulin resistance groups (). ③ The insulin resistance levels were positively correlated with BMI , diastolic blood pressure, triglyceride and postprandial insulin (, ), and had no relationship with fasting plasma glucose, postprandial plasma glucose, fasting insulin, systolic blood pressure, and