肥胖对老年人2型糖尿病胰岛素及C肽应答的影响

目的: 探讨肥胖对老年人2型糖尿病(DM)患者胰岛素(INS)和C肽(CP)应答的影响。方法: 选取2型糖尿病患者61例作为观察组,另选非糖尿病者58例为对照组,对两组均采用75g葡萄糖耐量试验(OGTT)及同步INS释放及CP释放试验,计算胰岛素敏感指数(ISI)。结果: DM组肥胖者1h INS低于对照组(P<0.05),余INS及CP应答在两组肥胖者间差异无显著性(P>0.05)。非肥胖型DM患者空腹及糖负荷后1h、2hINS及1h、2h、3hCP均减少(P<0.05~P<0.01)。DM组及对照组内肥胖者各时点INS及CP均显著高于非肥胖者(P<0.05~P<0.01),但肥胖者ISI显著低于非肥胖者(P<0.01)。结论: 肥胖老年人2型DM者INS水平虽然不低,但胰岛素抵抗(IR)显著。非肥胖老年人2型DM者主要是INS释放受损,但IR轻微。

Influence of obesity on insulin and C-peptide levels in elderly diabetic patients

Objective:To study the influence of obesity on insulin(INS) and C-peptide(CP) level of elderly patients with Type 2 diabetes.Methods:Sixty-one cases of type 2 diabetics were included in the observation group and 58 healthy people acted as controls.All the subjects underwent 75 g oral glucose tolerance test(OGTT),insulin release test,CP release test,and the insulin sensitivity index(ISI) was calculated.Results:The 1 h level of INS of the obese cases in the observation group was lower than those of the control group(P<0.05),INS and CP responses during the OGTT were similar in obese subjects of the two groups.The 1 h,2 h levels of INS,and 1 h,2 h,3 h levels of CP after sugar test were reduced in non-obese subjects of the two groups(P<0.05 to P< 0.01).The levels of INS,CP of all the points during INS and CP releasing tests were higher in the obese subjects of the two groups than those in the non-obese subjects(P<0.05 to P<0.01),but ISI reduced significantly in the non-obese subjects,compared with the obese subjects(P<0.01).Conclusions:Obese elderly patients with type 2 diabetics have adequate circulating insulin level,but marked insulin resistance(IR).Non-obese elderly patients with type 2 diabetic have a profound impairment in glucose-induced IR but mild resistance.