老年人不同糖耐量状态胰岛素抵抗和胰岛β细胞功能的研究

目的观察老年人群中空腹血糖受损(IFG)、糖耐量受损(IGT)和糖调节受损(IFG/IGT)三种不同糖耐量状态下的胰岛素抵抗(IR)和胰岛β细胞功能的变化,了解其发病机制。方法筛选60~75岁的IFG40例,IGT60例,IGT/IFG40例,正常糖耐量(NGT)70例。HOMA-IR评价胰岛素抵抗,HBC I和I30/G30分别评价基础及糖负荷后早期胰岛β细胞功能。结果(1)HOMA-IR:IFG、IFG/IGT和IGT组明显高于NGT组,P<0.01,IFG/IGT组高于IFG和IGT组,P<0.01;(2)HBC I:IFG组和IFG/IGT组明显低于NGT和IGT组,P<0.01;(3)I30/G30:IGT组和IFG/IGT组明显低于NGT组及IFG组,P<0.01。结论老年人群IFG主要表现基础状态下β细胞功能受损伴有胰岛素抵抗,IGT主要表现为早期胰岛素分泌缺陷,IFG/IGT胰岛β细胞早期胰岛素分泌功能受损更明显,胰岛素抵抗更严重。

The changes of insulin resistance and islet B cell function in the elderly with different status of glucose metabolism

Objective To investigate the changes of insulin resistance(IR)and function of islet B cell in the elderly with difference status of glucose metabolism.Methods The elderly subjects with isolated impaired fasting glucose(IFG,n=40),isolated impaired glucose tolerance(IGT,n=60),combined IFG and IGT(IFG/IGT,n=40)were studied,and nomal glucose tolerance(NGT)(n=70)was selected.Homeostasis model assessment(HOMA-IR) was applied to assess the status of insulin resistance,HBCI、I30/G30 after OGTT were used to evaluate the basic function and the early phase of insulin secretion of islet B cells,respectively.Results(1)HOMA-IR in group IFG,IGT and IGT/IFG was higher than that in group NGT(P<0.01),and HOMA-IR in group IFG and IGT/IFG were higher than that in group IGT(P<0.01)(2)HBCI in subjects with IFG and IFG/IGT were lower than those with IGT and NGT(P<0.01);(3)I30/G30 in subjects with IGT and IFG/IGT was lower than that with IFG and NGT(P<0.05).Conclusions The subjects with IFG mainly showed defect of basic B cell function and compainoning by insulin resistance;the subjects with IGT showed obvious defct of the early phase of insulin secretion,the subjects with IFG/IGT have more severe IR and defct of the basic and postload B cell function.