单纯餐后高血糖型糖尿病的胰岛素分泌与敏感性

目的评估单纯餐后高血糖型糖尿病(IPH)的胰岛素分泌与敏感性的特征,并进一步探讨进展为IPH的相关因素。方法850例受试者按75 g葡萄糖耐量试验分为:糖耐量正常(NGT)557例;单纯糖耐量异常(iIGT)146例;IPH 147例。比较各组的代谢指标及胰岛素分泌和胰岛素敏感性指数。结果早期相胰岛素分泌和胰岛素敏感性指数从NGT→iIGT→IPH逐渐降低,校正年龄和BM I后差异有统计学意义(P<0.05)。对iIGT和IPH患者作线性回归分析显示早期相胰岛素分泌和胰岛素敏感性指数与2hBG密切相关。结论初发的IPH有显著的早期相胰岛素分泌缺陷和胰岛素敏感性降低。β细胞胰岛素分泌缺陷和胰岛素抵抗均是从NGT→iIGT→IPH的进展过程中的决定因素。

Metabolic Characteristics of Insulin Secretion and Insulin Sensitivity in Isolated Postchallenge Hyperglycemia

Objective To evaluate the metabolic characteristics of insulin secretion and insulin sensitivity in isolated postchallenge hyperglycemia(IPH) and to clarify the factors responsible for the development of IPH. Methods(Eight hundred) and fifty subjects were classified into the following three groups based on the results of a 75-g oral glucose tolerance test(OGTT): normal glucose tolerance(NGT),n=557;isolated impaired glucose tolerance(iIGT),n=146;and IPH,n=147.Insulin secretion(insulinogenic index) and insulin sensitivity(insulin sensitivity index) were identified in the three groups. Results From NGT to iIGT and IPH in these subjects,the insulinogenic index and insulin sensitivity index were gradually decreased(P<0.05). Using linear regression analysis,the insulinogenic index and insulin sensitivity index were the significant factors in the 2hBG level in iIGT and IPH subjects.(Conclusion)Subjects with iIGT and IPH exhibited distinctly impaired early-phase insulin secretion and insulin sensitivity,indicating that both reduced insulin secretion and insulin resistance are the determinant of deterioration from NGT to iIGT and IPH.