中华内科杂志
中華內科雜誌
중화내과잡지
CHINESE JOURNAL OF INTERNAL MEDICINE
2012年
4期
299-303
,共5页
肖靖%田慧%李春霖%钟雯雯%孙般若%李昱芃%方福生%韩晓菲%刘永泉%成晓玲
肖靖%田慧%李春霖%鐘雯雯%孫般若%李昱芃%方福生%韓曉菲%劉永泉%成曉玲
초정%전혜%리춘림%종문문%손반약%리욱봉%방복생%한효비%류영천%성효령
高胰岛素血症%预后%糖耐量低减%β细胞功能
高胰島素血癥%預後%糖耐量低減%β細胞功能
고이도소혈증%예후%당내량저감%β세포공능
Hyperinsulinism%Prognosis%Impaired glucose tolerance%β cell function
目的 通过对中老年人群不同糖代谢状态进行调查分析,研究不同胰岛素水平对于糖耐量低减(IGT)患者向2型糖尿病(T2DM)转变的影响.方法 研究对象为2005-2007年在解放军总医院体检的北京居民,并根据口服葡萄糖耐量试验(OGTT)结果将人群分为正常糖耐量-非高胰岛素血症( NGT-NHIns)、糖耐量低减-高胰岛素血症(IGT-HIns)、糖耐量低减-非高胰岛素血症(IGT-NHIns)3组,以2009-2010年随访作为结点观察3组人群的转归情况.高胰岛素血症以空腹胰岛素≥15 mU/L和(或)糖负荷后2h胰岛素水平≥80 mU/L作为诊断标准.结果 IGT-NHIns组转变成T2DM的比例(42/133)较IGT-HIns( 24/154)、NGT-NHIns( 12/126)组要高.IGT-NHIns组稳态模型评估的胰岛素抵抗指数( HOMA-IR)比IGT-HIns组低[0.96 (0.40,3.53)比2.04(0.59,23.20),P＜0.05],但是全身胰岛素敏感性指数(WBISI)却要高于IGT-HIns组[7.48(3.20,31.35)比3.28(0.86,7.67),P＜0.05]；在评价β细胞功能方面,IGT-NHIns组新β细胞功能指数(MBCI)和胰岛素分泌指数(ISI)分别比IGT-HIns组差得多[2.57(0.58,10.98)比5.17(1.04,65.09)；7.66(0.99,28.40)比17.56(4.18,96.46),P值均＜0.01].结论 IGT-NHIns状态者发展到T2DM的风险高于IGT-HIns.预防IGT向糖尿病的转变,除了关注高胰岛素血症的危险外,对于胰岛素水平正常的IGT人群更应引起重视,早期加强危险因素控制有利于保护β细胞功能,延缓向糖尿病发展的进程.
目的 通過對中老年人群不同糖代謝狀態進行調查分析,研究不同胰島素水平對于糖耐量低減(IGT)患者嚮2型糖尿病(T2DM)轉變的影響.方法 研究對象為2005-2007年在解放軍總醫院體檢的北京居民,併根據口服葡萄糖耐量試驗(OGTT)結果將人群分為正常糖耐量-非高胰島素血癥( NGT-NHIns)、糖耐量低減-高胰島素血癥(IGT-HIns)、糖耐量低減-非高胰島素血癥(IGT-NHIns)3組,以2009-2010年隨訪作為結點觀察3組人群的轉歸情況.高胰島素血癥以空腹胰島素≥15 mU/L和(或)糖負荷後2h胰島素水平≥80 mU/L作為診斷標準.結果 IGT-NHIns組轉變成T2DM的比例(42/133)較IGT-HIns( 24/154)、NGT-NHIns( 12/126)組要高.IGT-NHIns組穩態模型評估的胰島素牴抗指數( HOMA-IR)比IGT-HIns組低[0.96 (0.40,3.53)比2.04(0.59,23.20),P＜0.05],但是全身胰島素敏感性指數(WBISI)卻要高于IGT-HIns組[7.48(3.20,31.35)比3.28(0.86,7.67),P＜0.05]；在評價β細胞功能方麵,IGT-NHIns組新β細胞功能指數(MBCI)和胰島素分泌指數(ISI)分彆比IGT-HIns組差得多[2.57(0.58,10.98)比5.17(1.04,65.09)；7.66(0.99,28.40)比17.56(4.18,96.46),P值均＜0.01].結論 IGT-NHIns狀態者髮展到T2DM的風險高于IGT-HIns.預防IGT嚮糖尿病的轉變,除瞭關註高胰島素血癥的危險外,對于胰島素水平正常的IGT人群更應引起重視,早期加彊危險因素控製有利于保護β細胞功能,延緩嚮糖尿病髮展的進程.
목적 통과대중노년인군불동당대사상태진행조사분석,연구불동이도소수평대우당내량저감(IGT)환자향2형당뇨병(T2DM)전변적영향.방법 연구대상위2005-2007년재해방군총의원체검적북경거민,병근거구복포도당내량시험(OGTT)결과장인군분위정상당내량-비고이도소혈증( NGT-NHIns)、당내량저감-고이도소혈증(IGT-HIns)、당내량저감-비고이도소혈증(IGT-NHIns)3조,이2009-2010년수방작위결점관찰3조인군적전귀정황.고이도소혈증이공복이도소≥15 mU/L화(혹)당부하후2h이도소수평≥80 mU/L작위진단표준.결과 IGT-NHIns조전변성T2DM적비례(42/133)교IGT-HIns( 24/154)、NGT-NHIns( 12/126)조요고.IGT-NHIns조은태모형평고적이도소저항지수( HOMA-IR)비IGT-HIns조저[0.96 (0.40,3.53)비2.04(0.59,23.20),P＜0.05],단시전신이도소민감성지수(WBISI)각요고우IGT-HIns조[7.48(3.20,31.35)비3.28(0.86,7.67),P＜0.05]；재평개β세포공능방면,IGT-NHIns조신β세포공능지수(MBCI)화이도소분비지수(ISI)분별비IGT-HIns조차득다[2.57(0.58,10.98)비5.17(1.04,65.09)；7.66(0.99,28.40)비17.56(4.18,96.46),P치균＜0.01].결론 IGT-NHIns상태자발전도T2DM적풍험고우IGT-HIns.예방IGT향당뇨병적전변,제료관주고이도소혈증적위험외,대우이도소수평정상적IGT인군경응인기중시,조기가강위험인소공제유리우보호β세포공능,연완향당뇨병발전적진정.
Objective To study the impact of different insulin levels on the conversion from impaired glucose tolerance (IGT) to type 2 diabetes mellitus (T2DM),through analysis of different glycometabolism condition among quinquagenarian population.Methods Subjects enrolled were Beijing habitants who received annual physical examination [ including oral glucose tolerance test (OGTI) ] in the Chinese PLA General Hospital from 2005-2007.According to the OGTT results,the subjects were divided into three groups,including normal glucose tolerance-non-hyperinsulinemia group (NGT-NHIns),IGT-hyperinsulinemia group (IGT-Hins) and IGT-non-hyperinsulinemia group (IGT-NHINS).The prognosis between the year 2009 and 2010 of the three groups was observed.Hyperinsulinemia was diagnosed with fasting serum insulin ≥ 15 mU/L and/or 2-hour serum insulin ≥ 80 mU/L after glucose loading.Results The rate of case number of conversion to T2DM in IGT-NHIns group (42/133) was higher than that in IGT-Hins group (24/154) or NGT-NHIns group (12/126).The HOMA insulin resistance index (HOMAIR) of individuals with IGT-NHIns was lower than that of IGT-Hins [ 0.96 (0.40,3.53 ) vs 2.04 (0.59,23.20),P ＜ 0.05 ],while whole body insulin sensitivity index (WBISI) was higher than that of IGT-Hins [ 7.48 (3.20,31.35 ) vs 3.28 ( 0.86,7.67 ),P ＜ 0.05 ].Modified β-cell function index ( MBCI ) and insulin secretion index (ISI) in IGT-NHIns was poorer than that of IGT-Hins respectively [ 2.57 (0.58,10.98) vs5.17(1.04,65.09); 7.66 (0.99,28.40) vs 17.56 (4.18,96.46),allPvalues ＜0.01].Conclusions The risk of IGT-NHIns progressing into T2DM is higher than that of IGT-Hins. For the prevention of T2DM,individuals with IGT-NHIns should be paid more attention than keeping an eye on IGT-Hins patients.Early control of risk factors could protect β cell function and prevent the progression to T2DM.
