空腹血糖与胰岛β细胞功能及胰岛素敏感性关系的研究

摘要

Objective To evaluate the change of p-cell function and insulin sensitivity when fasting plasma glucose (FPG) increased. Methods 1277 subjects from Jiangsu province were randomized into NGT, IFG, 1GT, IGR and T2DM groups by 75g OGTT. Insulin sensitivity was measured by ISI and 1/HOMA-IR. Β-cell function adjusted by insulin sensitivity was assessed by DI at basal DI0, early-phase DI30 and total Dl120. Results Compared with the NGT group, the ISI, DI0. DI30, DI120 were decreased by 25.2%, 17. 1%, 37. 2%, and 12. 5% respectively in the IGT group; 23.5%, 65.4%, 37.6%, and 37. 1% respectively in the IFG group; 42. 7%, 70. 1%, 56. 5%, and 38. 1% respectively in the IGR group; 44. 7% , 83. 4% , 76. 0% , and 66. 0% respectively in the T2DM group. Conclusion Both the impairment of p-cell function and insulin sensitivity start at the low point of FPG within the norrnoglycemic range and contribute to the deterioration of FPG.%目的 评估FPG与胰岛β细胞功能及IS之间的关系. 方法 采用多阶段分层整群随机抽样方法对江苏省1277例人群进行研究,根据OGTT分为NGT、IFG、IGT、IGR、T2DM组.IS用ISI及1/HOMA-IR评价;β细胞功能用经IS校正的处置指数DI(包括DI0、DI30、DI120)评估. 结果 同NGT组ISI、DI0、DI30、DI120相比,IGT组分别下降25.2％、17.1％、37.2％、12.5％;IFG组分别下降23.5％、65.4％、37.6％、37.1％;IGR组分别下降42.7％、70.1％、56.5％、38.1％;T2DM组分别下降44.7％、83.4％、76.0％、66.0％. 结论 在正常糖耐量阶段,随着FPG升高,IS和胰岛素分泌有下降趋势,两者共同促进FPG的升高.