CAJ | 학술논문

目的了解无糖尿病家族史、正常糖代谢肥胖女性体成分改变及胰岛β细胞功能变化.方法双能X线骨密度仪(DXEA)检测75名入选对象体成分,并行静脉葡萄糖耐量试验(IVGTT),按体重指数(BMI)水平分为4组.以胰岛素曲线下面积(AUCins)、胰岛素急性时相分泌(AIR)、稳态模型β细胞功能指数(HOMA2-%B)评估β细胞功能,以胰岛素抵抗指数(HOMA2-IR)、胰岛素曲线下面积/血糖曲线下面积(AUCins/AUCglu)评估胰岛素抵抗情况.结果随着BMI增加,入选对象总体脂含量、躯干脂含量均呈递增趋势,以躯干脂增加为主;IVGTT0和10 min血糖、AUCins、AIR、AUCins/AUCglu、10 min与0 min胰岛素差值[INS(10-0)]亦旱递增趋势.AIR、AUCins、Aucins/,AUCglu、INS(10-0)与年龄、BMI、总体脂含量、躯干脂含量均相关;控制年龄凶素后,躯干脂含量始终与AIR呈独立相关;且两者具有良好线性关系.结论肥胖女性存在以躯干脂增加为主的体成分改变和伴胰岛素抵抗的β细胞代偿性分泌增加.与BMI、腰围相比,体脂成分分析更能预测肥胖患者早期β细胞功能受损.
목적 료해무당뇨병가족사、정상당대사비반녀성체성분개변급이도β세포공능변화.방법 쌍능X선골밀도의(DXEA)검측75명입선대상체성분,병행정맥포도당내량시험(IVGTT),안체중지수(BMI)수평분위4조.이이도소곡선하면적(AUCins)、이도소급성시상분비(AIR)、은태모형β세포공능지수(HOMA2-%B)평고β세포공능,이이도소저항지수(HOMA2-IR)、이도소곡선하면적/혈당곡선하면적(AUCins/AUCglu)평고이도소저항정황.결과 수착BMI증가,입선대상총체지함량、구간지함량균정체증추세,이구간지증가위주;IVGTT0화10 min혈당、AUCins、AIR、AUCins/AUCglu、10 min여0 min이도소차치[INS(10-0)]역한체증추세.AIR、AUCins、Aucins/,AUCglu、INS(10-0)여년령、BMI、총체지함량、구간지함량균상관;공제년령흉소후,구간지함량시종여AIR정독립상관;차량자구유량호선성관계.결론 비반녀성존재이구간지증가위주적체성분개변화반이도소저항적β세포대상성분비증가.여BMI、요위상비,체지성분분석경능예측비반환자조기β세포공능수손.
Objective To explore the relationship between body composition and β-cell function in obese females with normal glucose metabolism. Methods Seventy-five obese women with normal blood glucose and without family history of diabetes were investigated. They were assigned to 4 groups based on body mass index (BMI). Body fat content was measured by dual-energy X-ray absorptiometry (DEXA), and intravenous glucose tolerance test (IVGTT) was performed. The acute insulin response (AIR), the area under the curve (AUC) of insulin (AUCins) and homeostasis model assessment (HOMA) for β-cell function (HOMA2-% B) were calculated. Insulin resistance index(HOMA2-IR) and the ratio of AUCins to AUC of glucose (AUCins/AUCglu) were calculated to assess insulin resistance. Results Women with higher BMI appeared to have more total body fat content and trunk fat content. The similar distribution was also found in other parameters, including the plasma glucose levels at 0 and 10 min, AUCins, AIR, AUCins/AUCglu and the difference of insulin level between 0 and 10 min [INS (10-0)] during IVGTF. AUCins, AIR, AUCins/AUCglu and [INS (10-0)] were positively correlated with the age, BMI,total body fat content and trunk fat content. After adjustment of age, the trunk fat content was independently associated with the AIR in a good linear manner. Conclusion The obese females show change in body composition with more trunk fat content. They show significant insulin resistance with compensated elevation of insulin secretion. Body composition assessment is a valid and more accurate method than BMI and waist circumference in predicting early damaged β-cell function in obese patients.