CAJ | 학술논문

目的比较高胰岛素-正常葡萄糖钳夹技术在正常糖代谢(NGT)、正常血糖高胰岛素血症( HINS)和糖耐量低减(IGT)3组不同糖代谢人群中建立条件的差异.方法应用高胰岛素-正常葡萄糖钳夹技术对10名NGT、11例HINS及10例IGT进行方法学研究,通过方差分析比较在3组人群中建立该技术的条件差异,用逐步回归分析探讨导致这种差异的影响因素.结果钳夹试验开始后,三组峰值和稳态期胰岛素浓度均＞ 100 mU/L,稳态时期血糖变异系数均＜5％,且内源性胰岛素和肝糖输出得到完全抑制.NGT组、HINS组和IGT组的稳态时期平均葡萄糖输注率(M值)分别为(11.6±1.7)、(6.1±1.9)和(6.0±1.5) mg· kg-1·min-1.钳夹过程中,峰值及稳态期胰岛素浓度在IGT组和HINS组均显著高于NGT组,而HINS组和IGT组间差异无统计学意义(P =0.34、0.11).影响峰值胰岛素浓度的独立危险因素为腰臀比,影响稳态时期胰岛素浓度的独立危险因素为胰岛素代谢清除率和体质指数,但M值并不受峰值和稳态时期胰岛素浓度的影响.结论在高胰岛素正葡萄糖钳夹实验建立过程中,NGT、HINS、IGT的峰值及稳态时期体内胰岛素水平存在差异,但并不影响M值对胰岛素抵抗水平的评估.
목적 비교고이도소-정상포도당겸협기술재정상당대사(NGT)、정상혈당고이도소혈증( HINS)화당내량저감(IGT)3조불동당대사인군중건립조건적차이.방법 응용고이도소-정상포도당겸협기술대10명NGT、11례HINS급10례IGT진행방법학연구,통과방차분석비교재3조인군중건립해기술적조건차이,용축보회귀분석탐토도치저충차이적영향인소.결과 겸협시험개시후,삼조봉치화은태기이도소농도균＞ 100 mU/L,은태시기혈당변이계수균＜5％,차내원성이도소화간당수출득도완전억제.NGT조、HINS조화IGT조적은태시기평균포도당수주솔(M치)분별위(11.6±1.7)、(6.1±1.9)화(6.0±1.5) mg· kg-1·min-1.겸협과정중,봉치급은태기이도소농도재IGT조화HINS조균현저고우NGT조,이HINS조화IGT조간차이무통계학의의(P =0.34、0.11).영향봉치이도소농도적독립위험인소위요둔비,영향은태시기이도소농도적독립위험인소위이도소대사청제솔화체질지수,단M치병불수봉치화은태시기이도소농도적영향.결론 재고이도소정포도당겸협실험건립과정중,NGT、HINS、IGT적봉치급은태시기체내이도소수평존재차이,단병불영향M치대이도소저항수평적평고.
Objective To compare the different establishing conditions of hyperinsulinemic euglycemic clamp technique among the groups of normal glucose tolerance (NGT),hyperinsulinemia with normal glucose (HINS) and impaired glucose tolerance (IGT).Methods The hyperinsulinemic-euglycemic clamp technique was applied to the study of methodology in 10 NGT,11 HINS and 10 IGT subjects.Different establishing conditions were compared through variance analysis (ANOVA) among three groups.And the influencing factors resulting in these differences were analyzed through stepwise regression analysis.Results The serum insulin concentration of three groups were acutely raised and maintained at above 100 mU/L. During the steady stage,the blood glucose level remained stable and all coefficient variations were under 5％. The secretion of endogenous insulin and hepatic glucose production were completely inhibited during the test.Under these steady-state hyperinsulinemic-euglycemic conditions,the glucose infusion rate (M value) was equal to glucose disposal rate by all tissues in body,M value of three groups were as follows:( 11.6 ± 1.7),(6.1 ± 1.9) and ( 6.0 ± 1.5 ) mg · kg-1 · min - 1 During clamping,the peak and steady-state serum insulin concentrations of IGT and HINS groups were significantly higher than those of NGT group. Although the peak and steady-state serum insulin concentration of HINS group were higher than those of IGT group,the differences had no statistical significance (P =0.34,0.11 ). The independent influencing factor of peak serum insulin concentration was waist-to-hip ratio (WHR) while the independent influencing factors of steady-state serum insulin concentration included insulin metabolic clearance rate (MCR) and body mass index (BMI).The peak and steady-state serum insulin concentrations were not the independent influencing factors of M value.Conclusion During the establishment of hyperinsulinemic-euglycemic clamp technique, the differences in peak and steady-state serum insulin concentrations existed among NGT,HINS and IGT groups.But the differences do not influence the use of M value in the evaluation of insulin resistance.