中国医师进修杂志
中國醫師進脩雜誌
중국의사진수잡지
CHINESE JOURNAL OF POSTGRADUATES OF MEDICINE
2010年
7期
4-6
,共3页
段素静%谌剑飞%谭薇%俞明辉%刘小鹏%严颂琴
段素靜%諶劍飛%譚薇%俞明輝%劉小鵬%嚴頌琴
단소정%심검비%담미%유명휘%류소붕%엄송금
葡糖耐量试验%动态血糖监测系统%胰岛β细胞分泌功能
葡糖耐量試驗%動態血糖鑑測繫統%胰島β細胞分泌功能
포당내량시험%동태혈당감측계통%이도β세포분비공능
Glucose tolerance test%Continuous glucose monitoring system%Islet β cell release function
目的 研究葡萄糖耐量减低(IGT)患者72 h动态血糖特征与早时相胰岛素分泌的相关性.方法 根据连续2次75 g口服葡萄糖耐量试验(OGTT)结果,选取正常糖耐量(NGT)组30例和IGT组32例.测定胰岛素水平,计算胰岛素抵抗指数(HOMA-IR)、胰岛素分泌指数(HOMA-β)、Δ130/ΔG30和胰岛素曲线下面积(AUCI).所有受试对象均行72 h动态血糖监测系统(CGMS)监测,分析比较两组餐后血糖峰值(PPG)、达峰时间(Δt)、餐后血糖波动幅度(PPGE)、餐后血糖波动持续时间(DPE).结果 IGT组的PPG、PPGE较NGT组明显升高(P<0.05),Δt、DPE明显延长(P<0.05).IGT组HOMA-IR高于NGT组(1.68 ±1.03比1.15±0.90)(P<0.01),Δ130/ΔG30和HOMA-β显著低于NGT组(3.85±1.04比6.42±1.05和52.97±2.02比55.68±12.45)(P<0.01或<0.05).结论 IGT患者以餐后血糖升高为特征,其糖负荷后的胰岛β细胞早时相分泌功能受损较重,空腹血糖和餐后2 h血糖的升高与胰岛素抵抗呈正相关,与胰岛β细胞功能呈负相关.
目的 研究葡萄糖耐量減低(IGT)患者72 h動態血糖特徵與早時相胰島素分泌的相關性.方法 根據連續2次75 g口服葡萄糖耐量試驗(OGTT)結果,選取正常糖耐量(NGT)組30例和IGT組32例.測定胰島素水平,計算胰島素牴抗指數(HOMA-IR)、胰島素分泌指數(HOMA-β)、Δ130/ΔG30和胰島素麯線下麵積(AUCI).所有受試對象均行72 h動態血糖鑑測繫統(CGMS)鑑測,分析比較兩組餐後血糖峰值(PPG)、達峰時間(Δt)、餐後血糖波動幅度(PPGE)、餐後血糖波動持續時間(DPE).結果 IGT組的PPG、PPGE較NGT組明顯升高(P<0.05),Δt、DPE明顯延長(P<0.05).IGT組HOMA-IR高于NGT組(1.68 ±1.03比1.15±0.90)(P<0.01),Δ130/ΔG30和HOMA-β顯著低于NGT組(3.85±1.04比6.42±1.05和52.97±2.02比55.68±12.45)(P<0.01或<0.05).結論 IGT患者以餐後血糖升高為特徵,其糖負荷後的胰島β細胞早時相分泌功能受損較重,空腹血糖和餐後2 h血糖的升高與胰島素牴抗呈正相關,與胰島β細胞功能呈負相關.
목적 연구포도당내량감저(IGT)환자72 h동태혈당특정여조시상이도소분비적상관성.방법 근거련속2차75 g구복포도당내량시험(OGTT)결과,선취정상당내량(NGT)조30례화IGT조32례.측정이도소수평,계산이도소저항지수(HOMA-IR)、이도소분비지수(HOMA-β)、Δ130/ΔG30화이도소곡선하면적(AUCI).소유수시대상균행72 h동태혈당감측계통(CGMS)감측,분석비교량조찬후혈당봉치(PPG)、체봉시간(Δt)、찬후혈당파동폭도(PPGE)、찬후혈당파동지속시간(DPE).결과 IGT조적PPG、PPGE교NGT조명현승고(P<0.05),Δt、DPE명현연장(P<0.05).IGT조HOMA-IR고우NGT조(1.68 ±1.03비1.15±0.90)(P<0.01),Δ130/ΔG30화HOMA-β현저저우NGT조(3.85±1.04비6.42±1.05화52.97±2.02비55.68±12.45)(P<0.01혹<0.05).결론 IGT환자이찬후혈당승고위특정,기당부하후적이도β세포조시상분비공능수손교중,공복혈당화찬후2 h혈당적승고여이도소저항정정상관,여이도β세포공능정부상관.
Objective To investigate the correlation between the early phase insulin secretion index and 72 h continuous glucose levels in patients of impaired glucose tolerance (IGT). Methods According to repeated 75 g oral glucose tolerance test (75 g OGTT) ,62 cases were divided into 2 groups: normal glucose tolerance group (NGT group, 30 cases) and isolated impaired glucose tolerance group (IGT group, 32 cases). Insulin levels were detected and HOMA-IR,HOMA-β , ΔI30/ΔG30,AUCI were calculated. The blood glucose levels were monitored by continuous glucose monitoring system for 72 h. The characteristics of postprandial glucose excursion were studied based on peak postprandial glucose (PPC) concentration, time to PPG (Δt) , postprandial glucose excursion (PPGE) and duration of postprandial glucose excursion (DPE). They were statistically analyzed by SPSS12.0. Results The levels of PPG and PPGE were significantly higher in IGT group (P < 0.05). Δt and DPE delayed obviously in IGT group (P < 0.05). HOM A-IR in IGT group was higher than that in NGT group (1.68 ± 1.03 vs 1.15 ± 0.90, P < 0.01), Δ I30/ΔG30 and HOMA- β was significantly lower in IGT group than that in NGT group (3.85 ± 1.04 vs 6.42 ±1.05,52.97 ± 2.02 vs 55.68 ± 12.45, P < 0.01 or < 0.05). Conclusions Higher postprandial glucose levels are characteristics of IGT patients,and the function of islet β cell after glucose load is impaired more severely. The levels of FPG and 2hPG are positively correlated with insulin resistance, and negatively correlated with islet β cell function.
