同济大学学报（医学版）2018，Vol.39Issue(1)：83-88,6.DOI:10.16118/j.1008-0392.2018.01.016
不同体质量指数糖尿病患者胰岛素分泌及胰岛功能的特点
Pancreatic beta-cell function and insulin resistance in type 2 diabetic patients with different body mass indexes
摘要
Abstract
Objective To investigate the pancreatic β-cell function and insulin resistance in T2DMpatients with different BMI.Methods The patients were divided into 4 groups:normal BMI group(18.5≤ BMI＜24,n =132),overweight group(24≤BMI＜28,n =142),mild obese group (28 ≤ BMI＜30,n =38)and severe obese group(BMI≥30,n =65).There were 157 patients with diabetes duration＜5 years,90 cases with duration of 5-10 years and 110 patients with duration ＞ 10 years.Lipid profile,FPG,FINS,HbA1c and insulin levels were measured;IS,HOMA-IR,AUCGlu,AUCINS,△I30/△G30,and DI were calculated to evaluate the insulin resistance and beta-cell secretion function.Results The age,FINS,HOMA-IR,AUCINS,DI,and △I30/△G30 in severe obesity group were significantly higher than those in normal BMI,overweight,and mild obesity groups(P＜0.001),while IS and HbAlc levels were lower significantly (P＜0.01).Patients in mild and severe obese group had significantly higher TG levels compared to normal BMI group,while there was no significant difference between mild and severe obese groups(P＞0.05).There were no statistical significances in TC,HDL-C,LDL-C,FPG,and AUCGlu among different BMI subgroups(P＞0.05).Patients with diabetic duration ＞10years had significantly lower BMI,AUCINS,DI,and △I30/△G30 than those with duration＜5 years and 5-10 years (P＜0.001),while there were no significant differences in FPG,FINS,HOMAIR,IS and AUCGlu among the three groups.After adjustment for sex,age,duration of diabetes and HbAlc,the FINS,HOMA-IR,AUCINS,DI,and △I30/△G30 in severe obesity group significantly increased and IS levels significantly decreased compared to the other three groups (P ＜ 0.001).Moreover,there were significant differences in TG and HDL-C levels,but not in TC,LDL-C,FPG and AUCGlu among the four groups.Correlation analysis showed that BMI was positively correlated with TG,FINS,HOMA-IR,AUCINS,DI and △I30/△G30 and negatively correlated with IS andHbAlc;while not correlated with TC,LDL-C,HDL-C,FPG and AUCGlu.Conclusion The insulin secretion and pancreatic β-cell function are decreased gradually with the increase of duration of diabetes.In patients with T2DM,the insulin sensitivity is decreased and insulin resistance is increased significantly,as well as functional compensation and insulin secretion is enhanced remarkably with the rising BMI.关键词
体质量指数/葡萄糖处置指数/胰岛素早期相分泌指数Key words
body mass index/glucose disposition index/early-phase insulin secretion index分类
医药卫生引用本文复制引用
郭庆妍,朱翠玲,卜乐,曲伸,崔冉,尤慧..不同体质量指数糖尿病患者胰岛素分泌及胰岛功能的特点[J].同济大学学报（医学版）,2018,39(1):83-88,6.基金项目
中央高校学科交叉类项目(1501219107) （1501219107）
国家自然科学基金(81570782、81500650) （81570782、81500650）
