CAJ | 학술논문

目的研究利用新HOMA稳态模型HOMA2计算的胰岛素敏感性指数(ISI)和分泌功能指数在临床的应用价值.方法选取80名志愿者,其中正常糖耐量(NGT)31人、糖调节异常(IGR)26人,2型糖尿病(T2DM)23人;抽取空腹血测定血糖、胰岛素(Ins)、真胰岛素(TI)和C肽水平,利用HO-MA2计算器分别计算三种ISI(HOMA2-%S-Ins、HOMA2-%S-TI和HOMA2-%S-C)和三种胰岛素分泌功能指数(HOMA2-%B-Ins、HOMA2-%B-TI和HOMA2-%B-C),比较上述指数区分不同糖耐量组的胰岛素敏感性和分泌功能变化的能力.结果在三种ISI中,利用空腹TI计算的HOMA2-%S-TI区分三组的胰岛素敏感性的能力相对最强(F=4.888,P＜0.01),利用空腹Ins计算的HOMA2-%S-Ins次之(F=3.397,P＜0.05),利用空腹C肽计算的HOMA2-%S-C不能区分三组的胰岛素敏感性(F=1.042,P＞0.05).利用HOMA2-%S-TI调整后,三种胰岛素分泌功能指数区分三组胰岛素分泌功能的能力非常接近(F值分别为60.323、58.203和58.179,P＜0.01),且均可很好区分IGR组和DM组的胰岛素分泌功能,其中只有HOMA2-%B-C可较好区分NGT组和IGR组的胰岛素分泌功能(t＝2.2709,P＜0.05).结论利用新HOMA稳态模型计算的HOMA2-%S-TI是一个相对较好的计算ISI的公式,HOMA2-%B-C是一个相对较好的计算胰岛素分泌功能指数的公式.
목적 연구이용신HOMA은태모형HOMA2계산적이도소민감성지수(ISI)화분비공능지수재림상적응용개치.방법 선취80명지원자,기중정상당내량(NGT)31인、당조절이상(IGR)26인,2형당뇨병(T2DM)23인;추취공복혈측정혈당、이도소(Ins)、진이도소(TI)화C태수평,이용HO-MA2계산기분별계산삼충ISI(HOMA2-%S-Ins、HOMA2-%S-TI화HOMA2-%S-C)화삼충이도소분비공능지수(HOMA2-%B-Ins、HOMA2-%B-TI화HOMA2-%B-C),비교상술지수구분불동당내량조적이도소민감성화분비공능변화적능력.결과 재삼충ISI중,이용공복TI계산적HOMA2-%S-TI구분삼조적이도소민감성적능력상대최강(F=4.888,P＜0.01),이용공복Ins계산적HOMA2-%S-Ins차지(F=3.397,P＜0.05),이용공복C태계산적HOMA2-%S-C불능구분삼조적이도소민감성(F=1.042,P＞0.05).이용HOMA2-%S-TI조정후,삼충이도소분비공능지수구분삼조이도소분비공능적능력비상접근(F치분별위60.323、58.203화58.179,P＜0.01),차균가흔호구분IGR조화DM조적이도소분비공능,기중지유HOMA2-%B-C가교호구분NGT조화IGR조적이도소분비공능(t＝2.2709,P＜0.05).결론 이용신HOMA은태모형계산적HOMA2-%S-TI시일개상대교호적계산ISI적공식,HOMA2-%B-C시일개상대교호적계산이도소분비공능지수적공식.
Objective To investigate the application of insulin sensitivity index and insulin secretion function index calculated by the new homeostasis model in clinic.Methods Eighty Chinese volunteers in Tianjin area (31 subjects for NGT group, 26 subjects for IGR group and 23 subjects for DM group) were involved in this study. Fasting blood samples were collected to measure the values of plasma glucose, insulin, true insulin and C peptide. Three insulin sensitivity indices (HOMA2-%S-Ins, HOMA2-%S-TI and HOMA2-%S-C) and three insulin secretion function indices (HOMA2-%B-Ins, HOMA2-%B-TI and HOMA2-%B-C) were calculated by the HOMA2 calculator. Results Among the three insulin sensitivity indices, the HOMA2-%S-TI calculated from plasma glucose and true insulin was relatively best (P<0.01) in distinguishing the insulin sensitivity of three groups, the HOMA2-%S-Ins calculated from plasma glucose and insulin was relatively better (0.05>P>0.01) and the HOMA2-%S-C calculated from plasma glucose and C peptide was relatively worse (P>0.05). After adjusted by HOMA2-%S-TI, the abilities of three insulin secretion function indices in distinguishing the insulin secretion function among three groups were very similar (F=60.3, 58.2 and 58.2 respectively, P<0.01), the abilities of them in distinguishing the insulin secretion function between IGR group and DM group were similar, meanwhile HOMA2-%B-C could distinguish the insulin secretion function between NGT group and IGR group (P<0.05). Conclusion The HOMA2-%S-TI calculated from the new homeostasis model is a better index in assessing the insulin sensitivity, and HOMA2-%B-C is a better index in evaluating the insulin secretion function.