老年2型糖尿病患者空腹血清真胰岛素水平与血脂的关系

目的　探讨老年 2型糖尿病 T2 DM(T2 DM)患者空腹血清真胰岛素水平与血脂的关系。方法　对正常糖耐量 (NGT)组 50例、T2 DM组 87例 T2 DM伴原发性高血压 (T2 DM EH)组 76例应用 BA- ELISA法测定空腹血清真胰岛素 (TI) ,应用放射免疫法测定免疫反应胰岛素 (IRI) ,应用酶法检测血脂。结果　 T2 DM组和 T2 DM EH组甘油三酯 (TG)与 TI呈显著正相关 (P<0 .0 1 ) ,高密度脂蛋白 (HDL- C)在 T2 DM和 T2 DM EH组与 TI呈负相关 (P<0 .0 5) ,TG、HDL- C与 IRI均无相关性 (P>0 .0 5)。结论　老年 T2 DM患者空腹血清 TI水平与脂代谢异常有关 ,空腹血清TI水平的升高会引起 TG的升高和 HDL- C的降低     

真胰岛素测定对胰岛β细胞功能和胰岛素抵抗的评价

目的　探讨血清真胰岛素 (TI)与免疫反应性胰岛素 (IRI)在反映胰岛 β细胞功能和胰岛素抵抗 (IR)方面的不同。 方法　测定正常糖耐量 (NGT)组 (75例 )、糖耐量减低 (IGT)组 (43例 )和 2型糖尿病 (T2DM )组 (54例 )的TI(ELISA法 )和IRI(RIA法 )水平 ,计算胰岛 β细胞功能指数 (HOMA β)和IR指数 (HOMA IR)。 结果　 (1 )HOMA βTI在IGT非肥胖组低于NGT非肥胖组 (P <0 0 5) ,T2DM非肥胖组低于NGT和IGT非肥胖组 (均P <0 0 1 ) ;在IGT和T2DM肥胖组低于NGT肥胖组 (均P <0 0 1 )。HOMA βIRI在IGT和T2DM非肥胖组低于NGT非肥胖组 (均P <0 0 5) ;在NGT、IGT和T2DM肥胖组之间无显著差异。(2 )HOMA IRTI和HOMA IRIRI在非肥胖组和肥胖组均显示T2DM有明显IR。结论　在反映胰岛 β细胞功能方面TI优于IRI,在反映IR方面TI与IRI有着相似的意义。     

血清瘦素水平与胰岛素原、真胰岛素及胰岛素敏感性的关系

目的　研究中国人群空腹瘦素水平与真胰岛素 (TI)、胰岛素原 (PI)、PI/TI比值及胰岛素敏感性之间的关系。方法　 90 2例非糖尿病者均系 2 0 0 0年接受糖尿病流行病学调查者。测定空腹瘦素、TI和PI浓度以及空腹及餐后 2h血糖。瘦素、TI及PI检测采用本室建立的特异的酶联免疫分析法 (ELISA)。胰岛素敏感性以HOMA胰岛素抵抗指数 (HOMA IR)评价。结果　血清瘦素水平女性高于男性。相关分析显示血清瘦素水平与空腹TI、PI及HOMA IR显著正相关 (男性 792例 ,r分别为0 345、0 2 36和 0 364 ;女性 1 1 0例 ,r分别为 0 574、0 375和 0 576 ,P <0 0 0 1 ) ,但与空腹血糖仅在男性呈弱相关 (r=0 1 5 ,P =0 0 1 5) ,与空腹PI/TI比值不相关。在调整年龄、体重指数 (BMI)和腰臀围比(WHR)后 ,尽管相关性减弱 ,瘦素水平仍然与TI、PI以及HOMA IR显著相关。结论　本组的血清瘦素浓度与TI、PI以及胰岛素抵抗显著正相关 ,且在一定程度上独立于肥胖和脂肪分布。瘦素水平高或瘦素抵抗的个体可能存在高胰岛素血症和胰岛素抵抗 ,提示其瘦素 胰岛素轴的调节异常。本研究未发现瘦素水平与空腹PI/TI比值的相关 ,提示瘦素可能与这一反映胰岛 β细胞的功能异常的标志无关。本研究揭示的高瘦素 高胰岛素血症或胰岛素抵抗之间的     

2型糖尿病病人的非糖尿病一级亲属胰岛β细胞功能和胰岛素抵抗的研究

目的　研究 2型糖尿病 (T2DM )及 2型糖尿病病人的非糖尿病一级亲属胰岛 β细胞功能、胰岛素抵抗 (IR)及早期胰岛素分泌功能 ,探讨其在糖尿病发生发展中的作用。方法　选取 59例正常对照组、58例T2DM病人糖耐量正常的T2DM病人一级亲属及 38例T2DM ,他们的体重指数 (BMI)均 <2 5kg/m2 ,计算并比较三组的血清胰岛素、血糖及稳态模型胰岛素抵抗指数 (HOMA IR)、β细胞功能指数 (HOMA β)及胰岛早期分泌指数 (△I30 /△G30 )。结果　非肥胖的糖耐量正常的一级亲属组的HOMA IR均高于正常对照 (P <0 0 5) ,但低于T2DM组 ;而HOMA βTI一级亲属组低于对照组 (P <0 0 5) ,但高于T2DM组 (P <0 0 1 ) ;△I30 /△G30 显示一级亲属组低于对照组 (P <0 0 5)。结论　非肥胖 2型糖尿病一级亲属在糖耐量正常时就已经存在胰岛β细胞功能的受损、胰岛素抵抗及胰岛素早期分泌指数减低 ;IR并非继发于肥胖和高血糖症。     

原发性高血压患者心率与胰岛素抵抗水平的相关性研究

目的 :研究原发性高血压 (EH)患者心率 (HR)与胰岛素抵抗 (IR)、血脂代谢、血压水平的关系。方法 :测定 2 0 5例EH患者 (男 85例 ,女 12 0例 )的HR、收缩压、舒张压 (DBP)、体重指数 (BMI)、血糖、胰岛素、总胆固醇、三酰甘油 (TG)、高密度脂蛋白胆固醇 (HDL C)、低密度脂蛋白胆固醇 ,稳态模式评估法计算IR指数(HOMA IR)。分析HR与其他各项参数的相关性。结果 :以HOMA IR 5 0 %位点作为判断IR的切割点 ,将EH患者分为IR组与胰岛素敏感 (IS)组 ,IR组HR[(84 .5± 11.9)次 /min]显著高于IS组 [(76 .8± 10 .8)次 /min]。HR与HOMA IR、DBP、TG呈显著正相关 ,与HDL C呈显著负相关 ;逐步回归分析显示 ,HOMA IR与TG为HR的独立预测因素 ;Logistic回归分析显示 ,HR与IR关系显著。 结论 :与IS的EH患者相比 ,伴IR的EH患者有较快的HR ;EH患者HR与IR、血脂代谢直接相关 ,独立于年龄、血压、BMI。     

非酒精性脂性肝脏疾病与胰岛素抵抗的关系

目的　探讨非酒精性脂性肝脏疾病 (NAFLD)脂代谢紊乱 ,胰岛素抵抗的情况及其与胰岛素抵抗、肿瘤坏死因子α(TNF α)水平的关系。　方法　采用病例对照研究 ,2型糖尿病 (T2DM )伴有脂肪肝组 (DF) 6 7例 ,T2DM不伴脂肪肝组 (NDF) 33例 ,脂肪肝组 (F) 2 1例 ,正常对照组 (NC) 18名。检测了 4组对象血脂、血糖和胰岛素 (空腹和 2h)、游离脂肪酸 (FFA)、TNF α,并通过CT定量评估了 2 6例DF组和 10名NC组对象肝脏脂肪含量。　结果　DF组与NDF组 ,F组与NC组比较 ,体重 (W )、体质指数 (BMI)、腰围 (W 1)、臀围 (H1)、腰臀比 (WHR)、胆固醇 (TC)、甘油三酯 (TG)、丙氨酸氨基转移酶 (ALT)、天门冬酸氨基转移酶 (AST)、TNF α、HOMA IR水平明显升高 (P <0 0 5 )。F组血糖和胰岛素 (空腹和 2h)水平高于NC组 (P <0 0 5 )。DF组FFA水平高于NC组 (P <0 0 5 )。多元逐步回归分析显示FBG、TG、BMI、脂肪肝是NAFLD胰岛素抵抗 (IR)的主要危险因素。不同程度的肝脏脂肪浸润程度 ,TC、TG、TNF α水平有显著性差异 (P <0 0 5 )。　结论　NAFLD存在IR。校正其他影响因素后 ,FBG、TG、BMI、脂肪肝是影响NAFLD病人IR的主要危险因素。     

2型糖尿病伴高甘油三酯血症患者血清胰岛素样生长因子结合蛋白1水平与胰岛素抵抗的相关性分析

目的探讨糖、脂代谢不同人群的血清胰岛素样生长因子结合蛋白1（IGFBP-1）水平与胰岛素抵抗（IR）的关系。方法选取正常人（NC）、高TG血症患者、2型糖尿病（T2DM）患者及T2DM＋高TG患者共66例,测定血清IGFBP-1、胰岛素、血糖和血脂水平。结果（1）血清IGFBP-1水平,高TG血症组较NC组、T2DM＋高TG组较T2DM组均明显下降（P〈0.05）。（2）多元逐步回归分析显示血清IGFBP-1水平与TG、HOMA-IR负相关（P〈0.05）,与HDL-C正相关（P〈0.05）。结论高TG血症人群血清IGFBP-1明显下降,提示存在明显肝脏IR。     

416名新诊断的中老年2型糖尿病患者胰岛素抵抗及胰岛素敏感性表征的分析

目的　比较新诊断的老年2型糖尿病(T2DM)患者与中年糖尿病患者胰岛素抵抗(IR)及胰岛素敏感性表征的异同点。　方法　将416 名 40 岁以上新诊断的 T2DM患者分为两组, 其中40~60岁(中年组)222例,60岁以上(老年组)194 例。分别测量血压(BP)、体质指数(BMI)、腰臀比(WHR)、检测糖化血红蛋白(HbA1c)、口服葡萄糖耐量试验、胰岛素分泌曲线、尿白蛋白及低密度脂蛋白胆固醇(LDL-C)、甘油三酯(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL C)等。按HOMA IR和HOMA βcell公式,计算糖负荷 30 min净增胰岛素/净增葡萄糖比值。　结果　初诊的老年T2DM患者与中年患者相比,其WHR、收缩压明显较高(P<0.05~0.01),而 BMI、葡萄糖刺激 2 h后的胰岛素分泌明显较低(P<0.05~0.01),同时空腹血浆TC、TG、LDL C、HDL C的水平也明显低于中年组(P均<0.01)。老年组有较高的胰岛素抵抗指数(P<0.05)和较低的β细胞分泌指数(P<0.01)及初期分泌指数(P<0.01)。　结论　与中年发病的糖尿病患者相比,老年糖尿病患者存在明显的 IR及胰岛素分泌缺陷,其 IR的主要表征为中心型肥胖、高血压、微量白蛋白尿。     

血清抵抗素水平与肥胖及2型糖尿病的关系

目的　研究血清抵抗素水平与肥胖、2型糖尿病 (T2DM )和胰岛素抵抗 (IR)的关系。　方法　用酶免疫测定法检测 31例单纯肥胖、2 7例T2DM及 30名正常人空腹血清抵抗素水平。　结果　单纯肥胖组、T2DM组及正常对照组空腹抵抗素分别为 ( 4 1± 13)、( 4 3± 11)和 ( 5 3± 7) μg/L。单纯肥胖组和T2DM组血清抵抗素浓度均低于正常对照组 (P <0 0 1)。空腹血清抵抗素与体质指数(BMI)、胰岛素抵抗指数 (HOMA IR)分别呈负相关 (r =- 0 2 92及 - 0 319,P <0 0 1) ,与空腹胰岛素、腰围和体脂百分比 (BF % )也呈负相关 (r =- 0 2 5 9,- 0 2 31及 - 0 2 39,P <0 0 5 )。多元逐步回归分析显示 ,HOMA IR为影响抵抗素最为显著的因素 (R2 =0 0 86 )。　结论　肥胖及T2DM患者血清抵抗素水平偏低。血清抵抗素与BMI、体脂百分比、腰围、空腹胰岛素和HOMA IR呈负相关。抵抗素可能在人类IR的发病中起一定的作用     

维吾尔族2型糖尿病家系非糖尿病一级亲胰岛素敏感性及β细胞功能

目的　研究维吾尔族 2型糖尿病 (DM )家系非糖尿病一级亲胰岛素敏感性及 β细胞功能。方法　收集新疆和田地区维吾尔族 2型DM家系 2 1个。在口服糖耐量试验 (OGTT)排除DM的前提下 ,选择先证者的一级亲为观察组 (89人 ) ,选先证者或其血缘亲属的配偶 (78人 ) (除外有DM家族史者 )作为对照组 ;比较两组HOMA β和HOMA IR。 结果　在正常OGTT情况下 ,DM家系一级亲组血浆空腹胰岛素和OGTT 2h胰岛素显著高于对照组 (均P <0 .0 5 )。观察组的HOMA IR高于对照组 (P <0 .0 5 ) ,HOMA β值两组差异无显著性。结论　维吾尔族DM家系非DM一级亲在正常糖耐量情况下已存在高胰岛素血症和胰岛素抵抗 ,但 β细胞功能无明显改变。     

Fasting serum insulin levels and insulin resistance are associated with colorectal adenoma in Koreans

Aims/Introduction

Insulin has been associated with the risk of colorectal cancer (CRC). However, few studies have evaluated the association between insulin and colorectal adenoma. We investigated the relationship between fasting serum insulin levels or homeostasis model assessment of insulin resistance (HOMA‐IR) and colorectal adenoma.

Materials and Methods

We retrospectively enrolled 15,427 participants who underwent both fasting serum insulin measurement and colonoscopy for a routine health examination at Asan Medical Center from January 2007 to December 2008. Participants with a history of any cancer, previous colectomy or polypectomy, those taking antidiabetic medications, and inflammatory bowel disease, non‐specific colitis, non‐adenomatous polyps only or CRC on colonoscopic findings were excluded. Finally, 3,606 participants with histologically confirmed colorectal adenoma and 6,019 controls with no abnormal findings on colonoscopy were included. Participants were categorized into quartiles (Q) based on fasting serum insulin levels and HOMA‐IR.

Results

Fasting serum insulin and HOMA‐IR were significantly higher in participants with colorectal adenomas compared with controls. Multivariate regression analysis adjusting for age, sex, smoking habits, drinking habits and family history of CRC showed that participants with higher quartiles of fasting serum insulin levels (odd ratio [OR] 1.17 for 2nd Q, 1.19 for 3rd Q, and 1.42 for 4th Q, P < 0.05) or HOMA‐IR (OR 1.18 for 2nd Q and 1.45 for 4th Q, P < 0.05) showed significantly increased ORs of colorectal adenoma compared with the lowest quartiles.

Conclusions

These findings showed that increased serum insulin levels and insulin resistance were significantly associated with the presence of colorectal adenoma.     

胰岛素抵抗高血压大鼠血清瘦素水平与胰岛素抵抗的关系

目的:探讨胰岛素抵抗高血压大鼠血清瘦素水平与胰岛素抵抗的关系。方法:以高果糖饲料喂养雄性SD大鼠复制胰岛素抵抗高血压大鼠模型,测定其收缩压(SBP)、空腹皿糖(FBG)、空腹血清胰岛素(FINS)和瘦素(LP)水平,用稳态模型(HOMA)评估胰岛素抵抗(IR),分析血清瘦素水平与胰岛素抵抗的相关性及与血压等其他指标的关系。结果:与对照组相比,模型鼠组SBP、FINS、HOMA-IR明显升高(P<0.01,P<0.01,P<0.05),FBG无明显变化(P>0.05);LP显著升高(P<0.05);模型鼠组的LP与FINS、SBP、HOMA-IR呈显著正相关(P<0.05)。结论:高果糖饲料喂养SD大鼠能形成胰岛素抵抗及高血压,并有高瘦素血症。瘦素与胰岛素抵抗的形成关系密切。     

高血压病患者的真胰岛素、胰岛素原水平及其与血压的关系

目的 探讨高血压病患的真胰岛素（TI）,胰岛素原（PI）水平及其与血压的关系,方法 测定非糖尿病的66例高血压病患及73例血压正常的收缩压（SBP）,舒张压（DBP）,血脂及口服葡萄糖耐量试验（OGTT）各点的血糖,血清TI和PI水平,TI及PI测定采用特异的单克隆抗体放大酶联免疫分析法（BA－ELISA）。结果 高血压病组在调整年龄,体重指数（BMI）和腰臂比（WHR）,其糖负荷后2h的PI及PI／TI水平显高于对照组（P＜0．05）,两而组间TI差异无统计学意义,单相关分析显SBP与空腹PI,2h PI及2h PI/TI 显相关,而BP仅与2h PI/TI显相关（P＜0．05）,仅在非肥胖组发现SBP与2hTI呈正相关（P＜0．05）,多因素回归分析显示2h PI独立于年龄,BMI,血糖和血脂等影响血压的混杂因素与SBP及高血压显相关。结论 本人群中高血压病患存在糖负荷后高PI血症,血清PI而非TI水平与高血压显正相关。     

胰岛素抵抗综合征患者血清脂联素和胰岛素敏感性的相关性研究

目的 检测正常人和胰岛素抵抗综合征患者血清脂联素,进一步探讨脂联素与胰岛素敏感性、血糖、血胰岛素、血脂等的相关性。方法 用减少样本数的Bergman微小模型技术结合静脉葡萄糖耐量试验检测正常、肥胖、糖耐量低减(IGT)和2型糖尿病(DM)患者的胰岛素敏感性指数(SI),同时测定受试者的体重指数(BMI)和腰臀比(WHR),检测空腹状态下脂联素和血脂、空腹和餐后2h血糖及胰岛素水平。结果 与正常组相比,肥胖、IGT和2型DM组的SI均显著降低,差异有显著性(P<0.001),而非正常组之间此指标差异无显著性。正常组的血清脂联素[(12.84±3.64)mg/L]显著大于肥胖、IGT和2型DM组[(7.65±2.45、7.55±2.64、5.19±2.36)mg/L,均P<0.001],后3组中2型DM组的脂联素显著低于肥胖和IGT组,差异有显著性(P<0.01,P<0.05),而肥胖组和IGT组间此值差异无显著性。脂联素与SI呈正相关,而与腰围、BMI、WHR和空腹、餐后2h血糖及血甘油三酯呈显著负相关。多元逐步回归分析提示血清脂联素与SI(r~2=0.29)、空腹血糖(r~2=0.26)、WHR(r~2=0.17)具有高度的相关性(均P<0.05)。结论 胰岛素抵抗综合征患者血清脂联素水平显著降低,并以2型DM患者降低更为明显;血清脂联素与SI呈正相关,而与空腹血糖和WHR呈显著负相关。     

Increased serum resistin in elite endurance athletes with high insulin sensitivity

Aims/hypothesis Resistin is an adipokine associated with obesity and type 2 diabetes in animal models, but in humans its role remains uncertain. This study was undertaken to test whether serum resistin is related to insulin resistance and markers of low-grade inflammation in elite athletes taken as a model of extreme insulin sensitivity.Subjects materials and methods In 23 elite athletes (sprinters, middle-distance and marathon runners) and in 72 sedentary men including lean and obese individuals with NGT, and obese individuals with IGT or new-onset type 2 diabetes, we assessed insulin sensitivity using a whole-body insulin-sensitivity index (WBISI) derived from a 3-h OGTT; energy homeostasis was also assessed by means of indirect calorimetry, along with circulating adipokines and low-grade pro-inflammatory cyto-chemokines.Results Professional athletes had increased WBISIs (p<0.001) and lipid oxidation (p<0.03); they also showed higher serum resistin concentrations (p<0.001), although the pro-inflammatory chemokines were not increased in comparison with the other study groups. Resistin was independently associated only with fasting plasma NEFA. Increased resistin was detected in the middle-distance and marathon runners, but not in the sprinters when compared with the lean, young, sedentary individuals.Conclusions/interpretation Serum resistin concentration is increased in elite athletes, providing evidence against the notion that resistin levels reflect insulin resistance in humans, as seen in animal studies. Increased resistin was observed in aerobic-endurance, but not sustained-power athletes and this feature appeared to be independently associated with parameters of fatty acid metabolism.     

Insulin-binding antibodies in serum of diabetic children treated with monocomponent insulin

Summary Levels of insulin-binding antibodies belonging to the IgG class were studied in diabetic children: 1) treated with monocomponent (MC) insulin Actrapid, semilente and lente Novo for 8–16 months (10 children); in 4 of these children the serum level of insulin-binding antibodies was followed up during a period of 5–7 months after changing MC insulin to commercial insulin; 2) treated with commercial insulin for 23 months to 12 years after diagnosis of diabetes (9 children). In 4 patients treated with MC insulin, antibody levels did not exceed threshold value (0.05 mU/ml). In 6 children insulin antibody levels rose markedly after virus infections (in 3 cases), bacterial infections (2 cases) and during treatment with polyvaccine (1 case). Insulin-binding antibody levels rose distinctly during treatment with commercial insulin in patients previously treated with MC insulin. In children suffering from diabetes of many years standing treated with commercial insulin, serum levels of insulin-binding antibodies were high (2.0 to 7.6 mU/ml), and in patients treated without insulin the serum contained no insulin-binding antibodies. The insulin requirement of the patients was not related to levels of insulin-binding antibodies. Supported in part by a grant from Section IV of the Polish Academy of Sciences.     

Dapagliflozin's effect on serum homocysteine in patients with hypertension complicated with insulin resistance

Most patients with hypertension are complicated with insulin resistance (IR), which is one of the risk factors of hypertension and can increase the level of serum homocysteine (Hcy) by affecting Hcy's metabolic enzyme and insulin level. Investigations in recent years have shown that Hcy is an independent risk factor for cardiovascular diseases. At present, folic acid is the prominent medicine used to reduce Hcy, but its effection for Hcy has an obvious individual difference, which is closely related to individual genes. Moreover, folic acid is chiefly used in patients with Hcy ≥15 μmol/L, but Hcy ≥10 μmol/L has had an adverse effect on the cardiovascular system. Randomized clinical trials have shown that dapagliflozin can improve IR. Therefore, whether it can reduce Hcy has become a new direction. This study was a retrospective case–control study. Patients with high serum Hcy and hypertension complicated with IR were divided into two groups: the dapagliflozin group (n = 166) and the control group (n = 198). Before and after 12 weeks of treatment, the changes in serum Hcy and IR index were measured and compared. We found that dapagliflozin could reduce the serum Hcy level of patients with hypertension and IR to a certain extent. Dapagliflozin could be a viable option for hypertension complicated with IR and hyperhomocysteinemia. However, these findings need to be further confirmed in future randomized clinical trials with a large number of samples.     

Treatment with insulin glargine does not suppress serum IGF-1.

AIMS: A 6-8-fold higher insulin-like growth factor 1 (IGF-1) receptor binding affinity in vitro is reported for the insulin analogue glargine compared with human insulin. This study evaluates the in vivo significance by exploring the growth hormone (GH)-IGF-1 axis. Assuming a higher binding affinity of insulin glargine to pituitary IGF-1 receptors, serum IGF-1 concentrations should decrease via negative feedback. METHODS: In a crossover study, insulin glargine or NPH insulin, respectively, were used in identical doses as basal insulins in treatment periods of 3 weeks. RESULTS: Overall glycaemic control was not different between the treatment regimens. In contrast to the hypothesis, serum IGF-1 concentrations were higher during insulin glargine treatment compared with NPH insulin in patients with Type 1 diabetes (177 +/- 18 vs. 159 +/- 18 microg/l, P < 0.02, n = 17, age 28 +/- 2 years). The effect on IGF-1 was most pronounced in male patients with Type 1 diabetes (174 +/- 11 vs. 146 +/- 10 microg/l, P < 0.02, n = 10), but was not significant in patients with Type 2 diabetes (92 +/- 9 vs. 86 +/- 8 microg/l, NS, n = 25, age 66 +/- 2 years). CONCLUSIONS: In contrast to our hypothesis, serum IGF-1 did not decrease, but rose during insulin glargine treatment, suggesting an absence of relevant IGF-1-like activity of glargine at the level of the pituitary. Improved plasma glucose at dawn during glargine treatment may intensify growth hormone surges and increase IGF-1 synthesis. Significant increases were seen in younger patients, compatible with the higher activity of the GH-IGF-1 axis in this age group.     

艾塞那肽对糖调节受损肥胖者血胰岛素及胰岛素抵抗的影响

目的探讨艾塞那肽对糖调节受损（IGR）肥胖者血胰岛素及血糖的影响。方法选取2011年5月至2012年11月在福建医科大学附属泉州第一医院就诊的75例糖调节受损（IGR）肥胖者为研究对象,其中62例受试者符合入选条件,按基线胰岛素水平分为高胰岛素血症（HIns,32例）与非高胰岛素血症（NHIns,30例）2组,HIns以空腹胰岛素≥15mU／L和（或）口服葡萄糖耐量试验（OGTr）2h胰岛素≥80mU儿作为切点。测定基线及应用艾塞那肽5d及14d时的空腹与OGTF2h血浆血糖、胰岛素、C肽、体重等指标。以稳态模型评估的胰岛素抵抗指数（HOMA-IR）及Gutt胰岛素敏感指数评估胰岛素抵抗及敏感性。同一组治疗前后比较采用配对t检验,组间均数比较采用单因素方差分析,率的比较采用x。检验。结果两组的空腹及OGTr2h血糖在用药5d时较基线下降（t=4．42、9．78、4．00、8．66,均P〈0．05）,HIns组空腹胰岛素在用药5d时较基线下降（t=2．07,P〈0．05）,OGTr2h胰岛素在用药5d较基线时下降,用药14d较5d时进一步下降（F=24．17,P〈0．05）。HIns组HOMA—IR在用药5d时较基线下降（t=3．27,只〈0．05）。NHIns组HOMA—IR在用药5d及14d时较基线均无下降（均P〉0．05）,HIns组Gutt胰岛素敏感指数在用药5d时较基线升高（t=-9．84,P〈0．05）,14d时较5d时进一步升高（F=55．96,P、遗0．05）。NHIns组Gutt胰岛素敏感指数在用药5d时较基线升高（t=-4．27,P〈0．05）。HIns组与NHIns组体重在5d时较基线无下降,14d时均较5d时明显下降（t=14．13、12．00,均P〈0．05）。结论IGR肥胖人群短期应用艾塞那肽即可获益调节血糖、改善胰岛素抵抗、控制体重。