CAJ | 학술논문

背景:糖耐量低减发病主要与遗传和环境因素有关,环境因素包括摄入热量过多和肥胖等.胰岛素抵抗是其主要发病机制之一.目的:探讨糖耐量低减患者的红细胞胰岛素酶活性(erythrocytes insulinase activity,EIA)与胰岛素抵抗的关系,为运动改善糖耐量低减患者的胰岛素抵抗提供理论支持.设计:以IGT患者为研究对象,以正常糖耐量的成年人为对照组的观察对比研究.单位:一所军医大学医院的内分泌科.对象:本研究于2001-01/2003-04在第一军医大学南方医院内分泌科完成.随机抽取住院和门诊的糖耐量低减患者50例,男26例,女24例,年龄(52±7)岁.纳入标准:符合WHO1999年口服葡萄糖耐量实验(OGTT)的糖耐量低减诊断标准,心、肝、肾功能和血常规均在正常范围,且未使用任何抗糖尿病药物者.排除标准:患肝脏、肾脏疾患、感染、恶性肿瘤、冠心病、脑血管意外和结缔组织疾病者.根据是否合并空腹血糖异常将糖耐量低减患者分为合并空腹血糖异常的糖耐量低减1组,共20例,男9例,女11例;单纯餐后高血糖未合并空腹血糖异常的糖耐量低减2组,共30例,男17例,女13例.20例正常糖耐量的成年人作为对照组,男女各10例,年龄(48±12)岁.方法:用放射酶分析法检测所有研究对象的EIA,同时检测患者的血糖、血清胰岛素和糖基化血红蛋白,并计算稳态模型胰岛素抵抗指数(Homeostasis Model Analysis-insulin resistance index,HOMA-IR)以评价机体的胰岛素敏感性.主要观察指标:各组EIA水平和HOMAIR指数的差异和相互关系.结果:糖耐量低减患者的EIA、血清空腹胰岛素和HOMA-IR指数显著高于对照组(P<0.01或P<0.05);糖耐量低减1组患者的EIA和HOMA-IR显著高于糖耐量低减2组(P<0.01);直线回归分析表明,糖耐量低减患者的EIA与血清空腹胰岛素、糖基化血红蛋白、HOMA-IR指数呈显著正相关(P<0.01).结论:糖耐量低减患者的红细胞胰岛素酶降解速度显著高于正常人,并与其胰岛素抵抗的发生、发展有密切相关性. 揹景:糖耐量低減髮病主要與遺傳和環境因素有關,環境因素包括攝入熱量過多和肥胖等.胰島素牴抗是其主要髮病機製之一.目的:探討糖耐量低減患者的紅細胞胰島素酶活性(erythrocytes insulinase activity,EIA)與胰島素牴抗的關繫,為運動改善糖耐量低減患者的胰島素牴抗提供理論支持.設計:以IGT患者為研究對象,以正常糖耐量的成年人為對照組的觀察對比研究.單位:一所軍醫大學醫院的內分泌科.對象:本研究于2001-01/2003-04在第一軍醫大學南方醫院內分泌科完成.隨機抽取住院和門診的糖耐量低減患者50例,男26例,女24例,年齡(52±7)歲.納入標準:符閤WHO1999年口服葡萄糖耐量實驗(OGTT)的糖耐量低減診斷標準,心、肝、腎功能和血常規均在正常範圍,且未使用任何抗糖尿病藥物者.排除標準:患肝髒、腎髒疾患、感染、噁性腫瘤、冠心病、腦血管意外和結締組織疾病者.根據是否閤併空腹血糖異常將糖耐量低減患者分為閤併空腹血糖異常的糖耐量低減1組,共20例,男9例,女11例;單純餐後高血糖未閤併空腹血糖異常的糖耐量低減2組,共30例,男17例,女13例.20例正常糖耐量的成年人作為對照組,男女各10例,年齡(48±12)歲.方法:用放射酶分析法檢測所有研究對象的EIA,同時檢測患者的血糖、血清胰島素和糖基化血紅蛋白,併計算穩態模型胰島素牴抗指數(Homeostasis Model Analysis-insulin resistance index,HOMA-IR)以評價機體的胰島素敏感性.主要觀察指標:各組EIA水平和HOMAIR指數的差異和相互關繫.結果:糖耐量低減患者的EIA、血清空腹胰島素和HOMA-IR指數顯著高于對照組(P<0.01或P<0.05);糖耐量低減1組患者的EIA和HOMA-IR顯著高于糖耐量低減2組(P<0.01);直線迴歸分析錶明,糖耐量低減患者的EIA與血清空腹胰島素、糖基化血紅蛋白、HOMA-IR指數呈顯著正相關(P<0.01).結論:糖耐量低減患者的紅細胞胰島素酶降解速度顯著高于正常人,併與其胰島素牴抗的髮生、髮展有密切相關性.
배경:당내량저감발병주요여유전화배경인소유관,배경인소포괄섭입열량과다화비반등.이도소저항시기주요발병궤제지일.목적:탐토당내량저감환자적홍세포이도소매활성(erythrocytes insulinase activity,EIA)여이도소저항적관계,위운동개선당내량저감환자적이도소저항제공이론지지.설계:이IGT환자위연구대상,이정상당내량적성년인위대조조적관찰대비연구.단위:일소군의대학의원적내분비과.대상:본연구우2001-01/2003-04재제일군의대학남방의원내분비과완성.수궤추취주원화문진적당내량저감환자50례,남26례,녀24례,년령(52±7)세.납입표준:부합WHO1999년구복포도당내량실험(OGTT)적당내량저감진단표준,심、간、신공능화혈상규균재정상범위,차미사용임하항당뇨병약물자.배제표준:환간장、신장질환、감염、악성종류、관심병、뇌혈관의외화결체조직질병자.근거시부합병공복혈당이상장당내량저감환자분위합병공복혈당이상적당내량저감1조,공20례,남9례,녀11례;단순찬후고혈당미합병공복혈당이상적당내량저감2조,공30례,남17례,녀13례.20례정상당내량적성년인작위대조조,남녀각10례,년령(48±12)세.방법:용방사매분석법검측소유연구대상적EIA,동시검측환자적혈당、혈청이도소화당기화혈홍단백,병계산은태모형이도소저항지수(Homeostasis Model Analysis-insulin resistance index,HOMA-IR)이평개궤체적이도소민감성.주요관찰지표:각조EIA수평화HOMAIR지수적차이화상호관계.결과:당내량저감환자적EIA、혈청공복이도소화HOMA-IR지수현저고우대조조(P<0.01혹P<0.05);당내량저감1조환자적EIA화HOMA-IR현저고우당내량저감2조(P<0.01);직선회귀분석표명,당내량저감환자적EIA여혈청공복이도소、당기화혈홍단백、HOMA-IR지수정현저정상관(P<0.01).결론:당내량저감환자적홍세포이도소매강해속도현저고우정상인,병여기이도소저항적발생、발전유밀절상관성.
BACKGROUND: Impaired glucose tolerance(IGT) is mainly related to genetic factors and environmental factors including excessive calorie intake and obesity. Insulin resistance(IR) plays a major role in the onset of IGT.OBJECTIVE: To investigate the relationship between erythrocyte insulinase activity(EIA) and IR in patients with IGT soas to provide theoretic basis for improving IR in patients with IGT by exercise.DESIGN: Observational and comparative study based on IGT patients as the subjects and adults with normal glucose tolerance as controls.SETTING: Department of endocrinology of a hospital affiliated to a military medical university.SUBJECTS: The study was conducted in the Department of Endocrinology of Nanfang Hospital, First Military Medical University of Chinese PLA, from January 2001 to April 2003. A total of 50 inpatients and outpatients with IGT, 26 males and 24 females aged(52 ± 7) years, were randomly selected. Inclusion criteria: those whose diagnosis met the WHO 1999 for criteria oral glucose tolerance test (OGTT) and whose heart, liver and kidney functions and blood test were within the normal range without taking any antidiabetics. Exclusion criteria: those who had liver and kidney diseases, infection, malignant tumor, coronary heart disease, cerebrovascular disorder and connective tissue disease. The patients with IGT were divided into 2 subgroups according to the presence of abnormal fasting plasma glucose (FPG).Subgroup A consisted of 20 patients (9 males and 11 females) with IGT accompanied with impaired FPG. Subgroup B was composed of 30 IGT patients (17 males and 13 females) with normal FPG. Twenty adults with normal glucose tolerance were set as control group(20 females and 10 males) with the age of(48 ± 12)years.METHODS: EIA was measured with the method of radioenzymatic assay in all subjects. Blood sugar, serum insulin and glycosylated hemoglobin were also measured, and homeostasis model analysis-insulin resistance (HOMA-IR) index was calculated for estimation of insulin sensitivity.MAIN OUTCOME MEASURES: The differences and correlation between EIA and HOMA-IR in IGT patients of each group.RESULTS: EIA, serum fasting insulin and HOMA-IR indexes of the patients with IGT were significantly higher than those of the controls ( P < 0.01 or P < 0.05) . EIA and HOMA-IR of the patients in subgroup A was significantly higher than those in subgroup B ( P < 0. 01 ). Linear regression analysis showed that EIA had significant positive correlation with serum fasting insulin, glycosylated hemoglobin and HOMA-IR indexes( r = 0.51, 0.44,0.49, P <0.01).CONCLUSION: The degradation rate of erythrocyte insulinase in patients with IGT tolerance is significantly higher than that of normal persons, and is closely related to the onset and development of insulin resistance.