葡萄糖耐量减低患者72小时动态血糖与早时相胰岛素分泌的相关性研究

目的 研究葡萄糖耐量减低(IGT)患者72 h动态血糖特征与早时相胰岛素分泌的相关性.方法 根据连续2次75 g口服葡萄糖耐量试验(OGTT)结果,选取正常糖耐量(NGT)组30例和IGT组32例.测定胰岛素水平,计算胰岛素抵抗指数(HOMA-IR)、胰岛素分泌指数(HOMA-β)、Δ130/ΔG30和胰岛素曲线下面积(AUCI).所有受试对象均行72 h动态血糖监测系统(CGMS)监测,分析比较两组餐后血糖峰值(PPG)、达峰时间(Δt)、餐后血糖波动幅度(PPGE)、餐后血糖波动持续时间(DPE).结果 IGT组的PPG、PPGE较NGT组明显升高(P<0.05),Δt、DPE明显延长(P<0.05).IGT组HOMA-IR高于NGT组(1.68 ±1.03比1.15±0.90)(P<0.01),Δ130/ΔG30和HOMA-β显著低于NGT组(3.85±1.04比6.42±1.05和52.97±2.02比55.68±12.45)(P<0.01或<0.05).结论 IGT患者以餐后血糖升高为特征,其糖负荷后的胰岛β细胞早时相分泌功能受损较重,空腹血糖和餐后2 h血糖的升高与胰岛素抵抗呈正相关,与胰岛β细胞功能呈负相关.

Study on the correlation between the early phase insulin secretion index and 72 hours continuous glucose levels in patients of impaired glucose tolerance

Objective To investigate the correlation between the early phase insulin secretion index and 72 h continuous glucose levels in patients of impaired glucose tolerance (IGT). Methods According to repeated 75 g oral glucose tolerance test (75 g OGTT) ,62 cases were divided into 2 groups: normal glucose tolerance group (NGT group, 30 cases) and isolated impaired glucose tolerance group (IGT group, 32 cases). Insulin levels were detected and HOMA-IR,HOMA-β , ΔI30/ΔG30,AUCI were calculated. The blood glucose levels were monitored by continuous glucose monitoring system for 72 h. The characteristics of postprandial glucose excursion were studied based on peak postprandial glucose (PPC) concentration, time to PPG (Δt) , postprandial glucose excursion (PPGE) and duration of postprandial glucose excursion (DPE). They were statistically analyzed by SPSS12.0. Results The levels of PPG and PPGE were significantly higher in IGT group (P < 0.05). Δt and DPE delayed obviously in IGT group (P < 0.05). HOM A-IR in IGT group was higher than that in NGT group (1.68 ± 1.03 vs 1.15 ± 0.90, P < 0.01), Δ I30/ΔG30 and HOMA- β was significantly lower in IGT group than that in NGT group (3.85 ± 1.04 vs 6.42 ±1.05,52.97 ± 2.02 vs 55.68 ± 12.45, P < 0.01 or < 0.05). Conclusions Higher postprandial glucose levels are characteristics of IGT patients,and the function of islet β cell after glucose load is impaired more severely. The levels of FPG and 2hPG are positively correlated with insulin resistance, and negatively correlated with islet β cell function.