2型糖尿病患者血清FFA变化与胰岛素抵抗关系的探讨

为了观察2型糖尿病患者空腹及口服759葡萄糖后血清游离脂肪酸（FFA）的变化，探讨体内胰岛素调节FFA的能力是否减弱以及FFA与胰岛素抵抗的关系。采用比色法测定60例2型糖尿病患者（女31例，男29例，平均年龄55．30±12．27岁）空腹及OGTT2小时血清FFA水平，并同步测定血糖（PG）、胰岛素（INS）。同法测30例正常人作对照。胰岛素敏感性指数（ISI）＝1／（空腹血糖FPG×空腹胰岛素FINS）。结果：2型糖尿病患者空腹及2小时血清FFA、PG、INS均显著增高，ISI显著降低，与对照组比较P值分别为＜0．05或＜0．01；多元逐步回归分析显示，2小时FFA与胰岛素敏感性指数（ISI）呈明显负相关（P＝0．0304）。以上结果提示：2型糖尿病患者不仅存在着空腹FFA异常，而且存在着INS抑制FFA代谢的异常，餐后FFA的异常升高也与INS抵抗有关。

Relationship Between the Changes of Serum Free Fatty Acids and Insulin Resistance in Type 2 Diabetics

The purpose of this study was to investigate the changes of serum free fatty acids (FFA) in fasting state and absorptive state and the relationship between FFA changes and insulin resistance in the patients with type 2 diabetes (DM2). 75g of glucose were given to 60 patients with DM2. Fasting serum FFA, serum insulin levels and the same parameters 2h after glucose load were measured by calorimetric and RIA methods. Fasting and 2h after oral glucose tolerance test (OGTT) plasma glucose(PG) levels were also assessed by using glucose oxidase method. The results showed the levels of serum FFA, PG and insulin of fasting and after glucose load in the patients were significantly increased and their insulin-sensitive index (ISI) was remarkably decreased as compared with those in 30 normal controls, P<0. 05. Multiple stepwise regression analysis showed that the FFA level of 2h after OGTT was negatively correlated with ISI, P=0. 0304. The results suggest that in patients with DM2, the levels of fasting and absorptive FFA are significantly elevated, which is negative1y correlated with the decline of ISI, implying the association of abnormal fasting and absorptive FFA and insulin resistance in patients with type 2diabetes.