Objective To analyze the relationship between different fasting blood sugar levels and insulin resistance and to explore the rationality of adult impaired fasting blood glucose cut point downward. Methods The grouping control study was adopted and the population receiving physical examination in the Physical Examination Center of Yancheng City No.l People's Hospital in Jiangsu Province from January 2008 to January 2009 were selected as the study subjects. The subjects were divided into four groups according to the fasting blood sugar level. Basic physical examination and the oral glucose tolerance test were conducted and the 2-hour plasma glucose (2 h PG) was measured. The homeostasis model assessment insulin resistance index (HOMA-IR) and the homeostasis model assessment islet beta-cell function (HOMA-B) were calculated using the homeostasis model assessment (HOMA). The relationship between the fasting blood sugar level and the insulin resistance was investigated using analysis of variance and partial correlation analysis. Results With the increase of fasting blood glucose, body mass index (BMI), waist circumference (WC), triglyceride (TG), fasting insulin (FINS), 2 h PG gradually increased, with statistically significant difference with the fasting plasma glucose <5.6 mmol/L group (P< 0.05), but the 6.1 mmol/L≤FPG<7.0 mmol/L group and the 5.6 mmol/L≤ FPG<6.1 mmol/L group were not significantly different in BMI, WC, TG, FINS and 2 h PG (P > 0.05). Partical correlation analysis showed that the imparied fasting blood glucose under the new cut point (5.6 mmol/L≤FPG<7.0 mmol/L) was in significant positive correlation to HOMA-IR (r = 0.52, P < 0.01) but in negative correlation to HOMA-B (r = -0.34, P < 0.01). Conclusion The population with FPG from 5.6 to 6.1 mmol/L has already undergone obvious insulin resistance and islet B cell hypofunction and is a high-risk population of type 2 diabetes (T2DM), thus the down-regulation of cut point is rational. Impaired fasting blood glucose under new cut point is in significant positive correlation to HOMA-IR but in negative correlation to HOMA-B. Insulin resistance is an independent risk factor for impaired fasting blood glucose.%目的 分析不同空腹血糖水平与胰岛素抵抗之间的关系,探讨成人空腹血糖受损切点下调的合理性.方法 采用分组对照研究,以2008年1月~2009年1月于江苏省盐城市第一人民医院体检中心进行健康体检人群为研究对象.根据空腹血糖水平分为4组.基本体检并进行口服葡萄糖耐量试验,测餐后2 h血糖(2 h PG).按稳态模式评估法(HOMA)计算稳态模式评估胰岛素抵抗指数(HOMA-IR)、胰岛β-细胞功能稳态模型评估(HOMA-B).用方差分析及偏相关分析来探讨空腹血糖水平与胰岛素抵抗之间的关系.结果随着空腹血糖(FPG)的升高,体重指数(BMI)、腰围(WC)、三酰甘油(TG)、空腹胰岛素(FINS)、2 h PG逐步上升,与FPG＜5.6 mmol/L组比较,差异均具有统计学意义(P < 0.05),但6.1 mmol/L≤FPG＜7.0 mmol/L组与5.6 mmol/L≤FPG＜6.1 mmol/L组,BMI、WC、TG、FINS、2 h PG无明显差异(P﹥0.05);应用偏相关分析发现新切点下的空腹血糖受损(5.6 mmol/L≤FPG＜7.0 mmol/L)与HOMA-IR具有显著的正相关(r = 0.52,P < 0.01),而与HOMA-B呈负相关(r = -0.34,P < 0.01).结论 FPG 5.6～6.1 mmol/L人群已经出现明显的胰岛素抵抗和胰岛B细胞功能减退,是2型糖尿病(T2DM)的高危人群,切点下调是合理的.新切点下空腹血糖受损与HOMA-IR具有显著的正相关,而与HOMA-B呈负相关,胰岛素抵抗是空腹血糖受损的独立危险因素.
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